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Archive: August 2020

A Big MYMP Landing!

Dr. Sharma, Dr. Larsen, Dr. Caza, NELL1, renal research
After several weeks of flying around our office, the MYMP landed and was caught by Dr. Caza, Dr. Larsen, and Dr. Sharma! Their newest paper discusses NELL1 and how it is a target antigen in malignancy-associated membranous nephropathy. Read the paper: NELL1 is a target antigen in malignancy-associated membranous nephropathy Who will catch the MYMP next?

Road To Renal with Dr. May

Dr. Murphy, Road to Renal, Dr. May, Arkana Podcasts
Our new fellow, Dr. May, began recording her new podcast this morning and her first guest was Dr. Murphy. He wanted to "dress up" for the occasion. Stay tuned for the first episode of Road to Renal with Dr. Rebecca May!  

Twitter Poll (August 19, 2020)

collapsing FSGS, twitter poll, Arkana Laboratories
Answer: A, Collapsing FSGS   HIV-associated nephropathy classically demonstrates collapsing FSGS. Other features include increased proximal tubule protein resorption droplets, and microcystic tubular dilatation. While this disease has markedly diminished in the presence of highly active antiretroviral therapy (HAART), the rate is still high in areas of sub-Saharan Africa. Within the United States, approximately 90% of cases occur in African Americans and are associated with genetic mutations in the APOL1 gene (G1/G2 alleles). The typical presentation is that of nephrotic syndrome secondary to widespread foot process effacement seen by electron microscopy. Interestingly, the CD4 count has not shown to be...

Back To School Donations

donations, Arkana Labs, giving back, Martin Luther King Jr. Elementary
Jack and JP (along with their Aunt Denise) stopped by this morning to help pack up school donations that Arkana has collected over the past few weeks. All donations are being given to the Martin Luther King Jr. Elementary School.  To make a contribution, visit the Little Rock School District's official website.

Diagnose This (August 17 ,2020)

Membranous Glomerulopathy, PLA2R, Diagnose This, renal pathology, Arkana Laboratories
Q: What is your diagnosis for this patient with nephrotic syndrome?   The electron photomicrograph demonstrates numerous subepithelial deposits along the glomerular basement membrane characteristic of a Membranous Glomerulopathy. Subsequent staining with an immunoperoxidase stain for Phospholipase A2 receptor (PLA2R) was strongly and diffusely positive in this case consistent with a primary Membranous GN. By light microscopy, the classic findings include thickened glomerular basement membranes and pinholes (or bubbles) and spikes that can be seen along the capillary loops with the Jones silver stain. However, it should be noted that the degree, or severity, of these findings can be extremely...

Diagnose This (August 10 ,2020)

Tags: Collapsing GN, Nephrotic syndrome, APOL1, G1/G2, transplant, COVID-19, Diagnose This
Q: What is your diagnosis?   The light microscopic image depicts a glomerulus with collapse of the capillary loops on the Jones methenamine silver stain. This lesion is identified by its prominent capillary loop collapse with overlying epithelial cell hyperplasia and hypertrophy, with associated protein resorption droplets. It is important to look at the background tubulointerstitium for findings that can be seen in association with this lesion such as increased proximal tubular resorption droplets, tubular microcystic tubular dilatation, and interstitial inflammation, as this lesion can be easily mistaken for crescent formation. Collapsing glomerulopathy can be seen as a primary (idiopathic)...

Twitter Poll (August 5, 2020)

Nail-Patella syndrome, Twitter Poll, Arkana Laboratories
Answer: A, Autosomal recessive inheritance Nail-Patella syndrome is a rare autosomal dominant disease with an incidence of approximately 1/50,000. The majority of cases are due to a mutation in LMX1B located at chromosome 9q34.1. The gene is important in development as it encodes a transcription factor important in dorsoventral pattern limb development, proper development of the anterior eye, neuron development within the CNS, and podocyte differentiation and maintenance. The kidney pathology is rather non-specific and can show minimal glomerular changes to variable degrees of FSGS with thickened capillary loops. By EM, the classic finding is that of "Moth-eaten" glomerular basement...

MYMP Alert!

collapsing glomerulopathy, Caza and Larsen, COVID-19, MYMP, Arkana Labs
Our MYMP made a special appearance today! Dr. Caza and Dr. Larsen teamed up with Dr. Velez to discuss the re-emergence of collapsing glomerulopathy with COVID-19. Read the paper: COVAN is the new HIVAN: the re-emergence of collapsing glomerulopathy with COVID-19 Stay on the lookout for the next MYMP sighting!  

Diagnose This (August 3 ,2020)

Fibrillary Glomerulopathy, Diagnose This!, Arkana Laboratories, pathology, nephropathology, renal pathology
Q: What is your leading diagnosis when seeing this interesting IgG staining pattern by IF?   The immunofluorescence shows a glomerulus with a very characteristic "smudgy" pattern of staining with IgG within the mesangium and along the capillary loops characteristic of Fibrillary Glomerulopathy. Fibrillary GN is an extremely rare disease, seen in <1% of native kidney biopsies and is caused by the deposition of fibrillar deposits of immunoglobulin within the mesangium with extension into the glomerular capillary loops. By electron microscopy, the fibrils are characterized as non-branching, randomly arranged, and have an average diameter of approximately 20 nm (range: 10-30...