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What is A 30 year old man presents with generalized edema and hypeension. Urine examination shows sub nephrotic proteinuria (< 2gm) and microscopic hematuria. Serum complement levels are decreased and he is positive for antihepatitis C antibodies. The most likely diagnosis is: and explain in detail?
Generalized edema, hypeension, sub-nephrotic proteinuria, hematuria, hypocomplimentemia and positive anti-hepatitis C antibodies are associated with Membranoproliferative Glomerulonephritis and Mixed Cryoglobulinemia. Mixed Cryoglobulinemia is more common in females and presents with stress ulceration, ahralgia, fatigue and Raynaud's phenomenon. Since the patient referred in this question is a male and does not present with specific features of cryoglobulinemia, MPGN proves to be the answer of choice. Ref: Harrison's Principles of Internal Medicine, 16th Edition, Page 1682; CMDT 2006 Edition, Page 925; Approach to Internal Medicine: A Resource Book for Clinical Practice, David Hui, 3rd Edition, Page 421.