28  years old male pt 
free past medical  history 

c/o  Generalized weakness for the last  2 months
he has long standing history for  generalized weakness 
no family history for renal disease 

he denied any history for  drug abuse 
no history for rheumatological disease 



labs showed 
wbc   6.9   hgb    9,8   plt   153
crp 1
creatinine   4.8   bun    45  
fbs   100
lDL   85 
HDL 37
TGD 58
TSH  1.8
Urine analysis   +3  protein  +3  blood 
wbc  12-15

abdominal us  showed  