In a non-diabetic patient, with positive IgG, kappa and lambda staining by immunofluorescence, what is your diagnosis?
The biopsy shows mesangial expansion by non-argyrophilic (Silver-negative) material. The main differential diagnoses for this finding are monoclonal immunoglobulin deposition disease (which is usually positive for a single light chain or immunoglobulin heavy chain, although rare cases of heavy and light chain deposition disease exist), and fibrillary glomerulopathy (FGN). The presence of fibrils ultrastructurally and positive DNAJB9 immunohistochemical staining (Figure 2) in this case helps confirm the diagnosis of fibrillary GN.
Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.
