Patient is a 41-year-old female without past medical history, who was referred for lower extremity edema and proteinuria.
Medications:
Ibuprofen, 1-2 tablets per month
Physical Exam:
1-2+ edema up to 1/3 of shin. Healthy appearing.
Laboratory and other data:
Creatinine 0.5 mg/dl, cholesterol 260-> 316 mg/dl, serum albumin 3.2-> 2.5 g/dl, protein/creatinine 2-3 g/g, serum PLA2R + with titer 1:160.
Short term follow up:
She was placed on ACEi/ARB, furosemide, and statin. A follow-up PLA2R titer was obtained at around 8 months, when her proteinuria appeared to remain persistent and additional support for treatment decision was being looked for. Her PLA2R titer now was 1:20.