A 16-year-old male without any systemic disease went to the doctor's office to complain of occasional headaches, which started 6 months ago.
His blood pressure was 150/90.
Laboratory results are as follow:WBC: 13400/L,Hemoglobin: 10.5mg/dl,Platelets: 243000/L,Blood Urea Nitrogen: 185,Creatinine: 2.9 mg/dL
Urine analysis: protein 3+, blood: 3+, RBC: 16-18 /LPF, granular cast: 2-3/LPF,24 h urine volume: 1400cc, 24 h Creatinine: 590 mg, 24 h protein: 998 mg, weight: 58 kgIn secondary work-up, he had a normal level of Complements.
FH: his mother and aunt’s have history of proteinuria and hematuria. They didn't have been evaluated
Microscopic scans:
Immunofluorescence study for IgG, IgA, IgM, C3c,C4c, C1q, and Albumin show No glomerular or tubular staining.
Fibrinogen highlighted cellular crescents.
Electron microscopy:
What is your diagnosis?