MRCP2-3997

MRCP2-3997

A 28-year-old female presents to the clinic with complaints of abdominal discomfort. She has been experiencing vague lower abdominal pain intermittently for several months. Although her weight has been stable, she occasionally loses her appetite. She is married and takes the combined oral contraceptive as her only medication. On examination, she appears well with a BMI of 24.5 kg/m2 and a blood pressure of 140/80 mmHg. No abnormalities are noted on chest, heart, or abdominal examination, and her neurology and fundoscopic examination are normal. Laboratory investigations reveal a serum urea level of 5.9 mmol/L (2.5-7.5) and a serum creatinine level of 90 µmol/L (60-110). Her urine dipstick shows the presence of blood and protein. An ultrasound scan of the abdomen reveals a small right kidney. What is the most likely cause of this patient’s presentation?