C3  gn
On myfortic  360 mg  2x2 
Carvidelol12.5  mg  2x2 
Valsartan   320 mg ocne


Came with albuminuria  of  2.7 mg/dl 

Plan 
Increase the  dose of valsartan  to  320 mg once 
Add  prednisone  30 mg ocne daily 
Follow up labs after   one month
27 YEARS 
PAST MEDICAL HISTORY 

2019    UTI:
Urine analysis     showed proteinuria 
2020   she  got  pregnant and she  found to have  Preeclapmsia ( 160/100 )  and then she  had Urgent  CS   at almizan hospital 

 After   few months   she has  24 hour urine collection   1  gram 
2021   she has the second pregnancy and she   she developed preecplasia  at  35  weeks and she had  CS 
SHE DELIVERED IN 2022 
2022  SHE HAD  Facial edema 
2022   she had kidney biopsy at 27/2/2023   at AVH 
Before the kidney bipsy she was maintained on 
Prednisone  40
Plaquuneil
Myfortic  360 mg 2x2 
ENA  negative

She was seen by  drmuath and he reported   her as acase of SLE 
She was seen by Hassansalama
She   stopped her medications  for  4 months 


Medication s
Carvideol  12.5   mg  2x2 
Atacand  16 mg once 
Myfortic  360 mg 2x2 

Hair  loos
No oral ulceration
No joint pain 
No  skin rash 
today 7/7
she   came today  with depression 
she still has proteinuria 
she started in forxiga

medications
myfortic  2x2
forxiga   10 mg once 
valsan  160 mg 1x2 
calcium
jdee

plan
stop  myfortic
add  nexium  40 mg 
do h pylori test 

7/9 
tSH  normal
cRP negative
uric acid   7
esr 32
wbc 6.4   hgb12.3  plt  211
creatinine  0.8
bun 19 
albumin  2.8

medciation
valsan  160  x2 
carvdelol 12.5  2x2 
forxiga  10 mg once 
myfortic    not started yet 
nexium  40 mg once not started yet 

4-1-2025
  creatinine bak  to 0.9 
albumin 3 
bun  18 
alt  ast  noraml 

wbc   6/9  hgb     11.2  low  mcv 
plt   228 
urine analysis showed   +3   protein  and  wbc  8-10
ESR   60

MEDICATION 
SHE HAS ALLERGY  OR  INTOERALCEN TO CRESTOR 
MEDICATION 
MYFORTIC  360 MG 1X2 
CARVIDEOLOL  12.5  1X2 
CALCIUM   600 MG  1X2 
SHE HAS   SINUSITIS 
AND EPIGASTRIC  PAIN 

Plan
PANTOVER   
Ferromed Plus 
OTRIVIN  NSALA  SPRAY 
She is planning    to g et pregancy 4i  have given her report  for imuran and prednione   and switcing the valsan  to  methyldopa   amicr  and  carvidelol 
folic  acid  on board 