CASE PRESENTATIONA 47-year-old man from rural Egypt presented 2 years ago with the complaint of general ill health, weight loss, and swelling of his legs. His recent illness had started 3 years earlier, when a massive hematemesis originated from severe antral gastritis with multiple erosions. Assessments showed evidence of schistosomal hepatic fibrosis, splenomegaly, and portal hypertension. He also had serologic evidence of hepatitis C viral (HCV) infection with minimal impact on hepatocellular function. He received multiple blood transfusions, was treated with proton pump inhibitors, and was eventually discharged in fair condition.A few weeks later, he noticed recurrent swelling of his legs, for which he received diuretics occasionally. Five months before presentation, his edema worsened. His general practitioner detected nephrotic-range proteinuria and prescribed a small dose of corticosteroids for 1 month. He had another episode of hematemesis, for which he received several pints of blood. However, he remained pale and asthenic, had persistent diarrhea, andThe Nephrology Forum is funded in part by grants from Amgen, Incorporated; Merck & Co., Incorporated; and Dialysis Clinic, Incorporated.