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Archive: October 2019

Twitter Poll: October 30, 2019

ANSWER: D ADPKD is genetically heterogeneous with two major genes, PKD1 and PKD2 (~90% families), and a rare third locus, GANAB lately discovered. Less than 10% of ADPKD families are negative for these genes. More recently, DNAJB11 has been identified in those patients from ADPKD-negative pedigrees. For the blog: ADPKD is the most common inherited kidney disorder. Two genes PKD1 and PKD2, coding for membrane proteins involved in the primary cilium, account for more than 90% of typical cases of ADPKD. A third gene, GANAB coding for the α-subunit of the endoplasmic reticulum-resident enzyme glucosidase II, has been associated with...

Fellowing Joel: Episode 7

[video width="1920" height="1080" mp4="https://www.arkanalabs.com/wp-content/uploads/Fellowing-Joel-Ep-7.mp4"][/video] This week we caught Dr. Murphy behind the scope with Dr. Kuperman as he was asked to explain his diagnosis of a tricky case.    

Art of Medicine: Thrombotic Microangiopathy

The above painting shows a glomerulus containing capillary loop fibrin thrombi, an arteriole with onion-skinning, and acute tubular injury, findings that can be seen in thrombotic microangiopathy.  Morphologic findings of thrombotic microangiopathy that can be seen on a renal biopsy include arteriolar or capillary loop fibrin or platelet thrombi, red blood cell fragmentation within glomerular capillary loops or within arteries, mesangiolysis, endothelial cell swelling,  glomerular basement membrane duplication, mucoid intimal edema of arteries, and a myointimal proliferation surrounding arterioles (onion-skinning like reaction). Thrombotic microangiopathy (TMA) has a wide clinical differential diagnosis, which can have substantial morphologic overlap on a kidney...

Endocarditis-Associated Glomerulonephritis

The patient is a 45-year-old IV drug user who presents with fevers, chills, hematuria, and fatigue. On laboratory testing, he was found to have a creatinine of 4.8. Complement levels are depressed and blood cultures are positive. A transesophageal echocardiogram confirmed the presence of endocarditis. A kidney biopsy was obtained due to hematuria. Image 1 and Image 3 shows circumferential cellular crescents with fibrinoid necrosis (many intracapillary neutrophils are seen in image 3). Figure 2 shows severe interstitial fibrosis. Images 4 and 5 show immunofluorescence staining with IgM and C3, respectively. This is a case of endocarditis-associated glomerulonephritis with diffuse...

River the Office Dummy

Last week Gail pulled her dummy from the closet (he goes by River around here) to set him up as someone taking a nap in the common space. Since then, River has entertained a visitor... Caught up on some reading... And started to plan his Halloween costume!  He's really been checking things off of his to-do list this past week.    

Arkana Employee Spotlight: Kaleigh

Meet Kaleigh Miskin. Kaleigh is a cytologist and histologist who joined our lab in 2015.  She received her cytotech degree from University of Arkansas for Medical Sciences in 2015 and became a licensed histotechnologist in 2017. Her knowledge, ability, and attitude led to her promotion to Assistant Lead in the Light Microscopy section of our laboratory in 2018.  Co-workers describe Kaleigh as kind, positive, organized and patient. She leads by example and is quick to jump in to help without complaint. Likewise, Kaleigh says her favorite part about working at Arkana is the environment. "There are nice people, we get...

Fellowing Joel: Episode 5

This week Dr. Murphy learned a lesson in Arkana culture.  [video width="1920" height="1080" mp4="https://www.arkanalabs.com/wp-content/uploads/IMG_1387-1.mp4"][/video]

Disease Week: Infection-Associated Glomerulonephritis and Endocarditis-Associated Glomerulonephritis

A paradigm shift has occurred in the epidemiology, bacteriology, and clinical and pathologic findings of infection-associated glomerulonephritis over the past few decades.  The incidence of acute Streptococcal glomerulonephritis has declined, in part due to improved socioeconomic conditions and the advent of antibiotic therapy in developed countries.  An increase in methicillin-resistant and sensitive Staphylococcal infections ranging from superficial skin infections to deep-seated occult infections such as visceral abscess, osteomyelitis, and endocarditis has been noted.  This increase is seen in the expanding elderly population who have increasing comorbidities of diabetes and heart disease and increased use of cardiac devices, indwelling catheters and...

Fellowing Joel: Episode 4

[video width="1920" height="1080" mp4="https://www.arkanalabs.com/wp-content/uploads/IMG_1387.mp4"][/video] This week we caught Dr. Murphy while learning our EM process.