### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I had a skin biopsy and it was demined that I have Vacuities. Although I ve only gotten the rash about 4 times I recently had 3 urine tests that are showing trace amounts of blood and protein in the past 2 months. I have now been referred to a nephrologist that I cant see for about 3-4 weeks and no one really seems too concerned except for me. I do have Celiacs as well and that caused a rash as well. Been gluten free since Oct 2013. I can see white floaties in my urine and try to drink plenty of water. Ive read that the kidneys can be involved so Im scared. They say I don t have to avoid anything (eating, drinking and so on) but again Im concerned. What will be the next logical step for my new doctor so I can be prepared?

### output:

Dear Patient, do you have more details on your skin biopsy? Was I T IGA positive? Your kidneys may be affected by Schooling Enoch purpura, ANNA vasculitis or a so-called monoclonal gammopathy of renal significance. Do a complete immunological test including C3, C4, ANA, EN ZA, Egg, IGA, IGM, Kappa and Lambda free light chains (serum) and total light chains in purines, STEP, PEP, total 24h proteinuria and luminaria, HBO, CV. This is a basic screening that gives us lots of information of what is going on. Then, if your renal function is good, and you have only mild urinary signs of activity, you can delay a renal biopsy, that otherwise is mandatory. Let me know,