Doctordle Today: Daily Medical Diagnosis Puzzle

Diagnosis

Membranous Nephropathy

Membranous Nephropathy is a glomerular disease characterized by subepithelial immune deposits causing nephrotic syndrome. It is caused by autoantibodies against podocyte antigens such as PLA2R or secondary immune-complex deposition. Common symptoms include edema, foamy urine, and complications of nephrotic syndrome. Workup includes urine protein quantification, anti-PLA2R antibodies, and renal biopsy showing granular IgG deposits and basement membrane spikes. Treatment involves supportive antiproteinuric therapy and immunosuppression such as rituximab for higher-risk disease.

Full clinical clue sequence

1. A 45-year-old woman presents for evaluation of bilateral leg swelling, left>right.
2. Blood pressure is elevated to 172/93. Other vitals are within normal limits.
3. Physical exam reveals 3+ pitting edema in bilateral lower extremities, periorbital edema, and erythema of the left leg.
4. Ultrasound confirms the presence of deep vein thrombosis in the left lower extremity.
5. Laboratory studies reveal an albumin of 1.2 and 4.5 g/day of proteinuria.
6. Antibody testing confirms the presence of anti-PLA2R.