8th February 2024

A 27-year-old female presents with unintentional weight loss associated with fevers and night sweats over recent weeks.

A 27-year-old female presents with unintentional weight loss associated with fevers and night sweats over recent weeks. She also complains of general malaise and has stopped drinking recently due to abdominal pain on consumption of alcohol. On examination, she has painless cervical lymphadenopathy, abdominal distension and peripheral oedema. Bloods reveal a low albumin. A 24-hour urine collection reveals significant urinary protein excretion. Renal biopsy shows no significant abnormality.

What is the most likely cause of her renal pathology?