26   YEARS OLD FEMALE 
HYPOTHYROIDISIM   FOR THE LAST   14  YEARS 
Gestational dm  in the last   DM    Pregnancy 
she had  2  pregancies   1  in 2021 -   2023  


preeclampsia  in the  first pegancy    
seond  pregancy in 2023  she  found to have proteuria  since the  third  month 
she  followed her  pregnancy  and  along the pregancy she had  proteinuria 
in 11/2024  she     discovered to have DM  with hba1c  11
she    was strted on insulin and empa 
her  test has imroved to 6  hba1c

she  found to  have  high protein  in urine  >  1200 
for  which  she was  sent  to us by dr  anas 


HAB     6 
ALBUMIN  /CREATININE  RATIO  128  MG   /MG 

TSH   4.7 
CREATININE   0.7   BUN    10 
NA   138  K     4.1   CL  102 
PCR       137 MG/MG 
C-  [E[TOD    3.4 
TSH   4.2 


MEDICATIONS 
XIGDUE    10/1000 

PLAN 
ADD  DIOVAN 80 MG OCNE  
ADD  J DEE   50000  ONCE WEEKLY D
O  AUTOIMMUNE PROFIKE 
DO ENAL US 
CONSIDER KIDNEY  BIOPSY 