Older woman presents to the physician after experiencing severe coughing with blood. She has a history of smoking and high blood pressure. No fever or shortness of breath. She has infiltrates bilaterally on xray. Urinalysis is as follows: proteinuria, hematuria, and RBC casts are shown. The range of proteinuria is subnephrotic. What is the differential dx?
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The presentation of high blood pressure, hematuria and RBC casts indicate a nephritic syndrome. One would then use light microscopy, electron microscopy, and clinical presentation to narrow the field.