A 28-year-old woman with systemic lupus erythematosus has new edema. Urinalysis shows 3+ protein, red blood cell casts, and urine protein-creatinine

Question

A 28-year-old woman with systemic lupus erythematosus has new edema. Urinalysis shows 3+ protein, red blood cell casts, and urine protein-creatinine ratio 1.8 g/g. Creatinine has risen from 0.7 to 1.1 mg/dL. Which of the following is the most appropriate at this time?

Accepted Answer

Arrange kidney biopsy

Answer

Treat with NSAIDs alone

Answer

Reassure because creatinine is within reference range

Answer

Schedule elective cholecystectomy

Answer

Start empiric antibiotics for cystitis

Lupus nephritis — USMLE Step 3 MCQ

A 28-year-old woman with systemic lupus erythematosus has new edema. Urinalysis shows 3+ protein, red blood cell casts, and urine protein-creatinine ratio 1.8 g/g. Creatinine has risen from 0.7 to 1.1 mg/dL. Which of the following is the most appropriate at this time?