Medicine

A 28-year-old woman has noticed increasing lower limb swelling and shortness of breath. She has a 2-year history of facial rash, hair loss, arthralgias, and thrombocytopenia. On examination, her blood pressure is 150/90 mmHg, pulse 80/min, there is a maculopapular rash on her face, JVP is 4 cm, heart sounds normal, lungs clear, and there is pedal and periorbital edema. Her creatinine is very high, a urinalysis reveals many RBCs and RBC casts. A renal biopsy is performed.For the above patient with GN, select the most likely diagnosis on renal biopsy.