Seropositive Rheumatoid Arthritis 3 in Medicine / Internal Medicine — 52yo Woman | Rheumatology | SMLE Q#336
SMLE Question #336
Medicine / Internal Medicine
Rheumatology
Last updated: February 2026
A 52-year-old woman with seropositive rheumatoid arthritis presents 3 weeks after being treated for community-acquired pneumonia with worsening fatigue, dark urine, decreased urine output, and new bilateral leg swelling. She received IV antibiotics in hospital, then oral antibiotics after discharge. Urinalysis shows numerous dysmorphic red blood cells and red blood cell casts with mild proteinuria. Serum creatinine has risen from 80 µmol/L (before pneumonia) to 203 µmol/L. What is the most likely cause of her kidney dysfunction?
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