Question

54 yo woman with history of lupus comes to the office with increasing significant peripheral edema over the past four days. Lab findings include marked proteinuria, hypoalbuminemia, and hyperlipidemia. Dx study that is best for determining the cause of the proteinuria

Answer 1

A 54-year-old woman with lupus experiencing peripheral edema, marked proteinuria, hypoalbuminemia, and hyperlipidemia is likely suffering from nephrotic syndrome, which is suggested by the symptomatology. A renal function evaluation, including a renal biopsy, would be the best diagnostic step to identify the cause of proteinuria.

Step-by-step explanation:

The clinical presentation of the 54-year-old woman with lupus experiencing significant peripheral edema, marked proteinuria, hypoalbuminemia, and hyperlipidemia suggests that she may be suffering from a renal condition such as nephrotic syndrome. This syndrome is characterized by damage to the glomeruli, which allows proteins to leak into the urine, resulting in proteinuria.

The best diagnostic study for determining the cause of proteinuria in this case would be a detailed evaluation of renal function, including specific tests such as a renal biopsy to identify the extent and type of glomerular damage, in addition to other investigations like serum creatinine, blood urea nitrogen (BUN), and possibly imaging studies like an ultrasound or MRI of the kidneys. These tests help in delineating the cause of the edema and the associated abnormalities in the lab findings.