1. Presented by Mark Haas, M.D. and prepared by Carol Allan, M.D.

A 77 year old woman presents with acute renal failure. Her serum creatinine is 7.3 mg/dL, up from 1.6 mg/dL one month ago. Urinalysis shows 3+ protein and many RBCs. P-ANCA is positive at 1:160, C-ANCA and anti-GBM antibody are negative. Serum complements are normal. Chest x-ray shows bilateral lung infiltrates.

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