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Twitter Poll (November 25, 2020)

twitter poll, calcium oxalate, renal pathology, arkana laboratories
Answer: B Ethylene glycol toxicity due to oral ingestion classically shows acute tubular injury characterized by epithelial simplification, loss of brush border, vacuolization, and reactive nuclear changes in association with intratubular calcium oxalate deposition. Of note, these crystals are polarizable whereas calcium phosphate crystals are not.  

Diagnose This (November 23, 2020)

C3-dominant immune-complex, neutrophilic endocapillary hypercellularity, diagnose this, renal pathology, kidney biopsy, arkana laboratories
Based on the image provided, what would be your leading diagnosis with C3-dominant immune-complex deposition?       ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​...

Diagnose This (November 16, 2020)

glomerulomegaly, arkana laboratories, renal pathology, diagnose this, kidney pathology
  What conditions would be in your differential diagnosis for this finding? (Hint: large glomerulus)       ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​...

Twitter Poll (November 11, 2020)

NCAM-1, NCAM-1 associated membranous nephropathy, PLA2R, Twitter Poll, Arkana Laboratories
Answer: B In a recent article by Caza et al, NCAM-1 associated membranous nephropathy has been shown to be associated with systemic lupus erythematosus. Clinically, the article showed that the cases had a female predominance and were seen in younger patients than that typically seen in PLA2R or THSD7A-associated membranous nephropathy. In their cohort, NCAM-1-associated membranous made up approximately 7% of all membranous lupus nephritis cases (see reference).   Reference: Caza T, Hassen S, Kuperman M, et al (in press). Neural cell adhesion molecule 1 is a novel autoantigen in membranous lupus nephritis. Kid Int (2020) DOI: https://doi.org/10.1016/j.kint.2020.09.016.  

Diagnose This (November 2, 2020)

Alport Syndrome, Arkana Laboratories, diagnose this, renal pathology, kindey path, kidney disease
What is this finding? In a young male patient with hematuria and hearing loss, what would be your top diagnosis?       ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​  ...

Twitter Poll (October 28, 2020)

Medullary angiitis, renal pathology, kidney disease, arkana laboratories
Answer: C Medullary angiitis is a histopathologic lesion within the renal medulla that is characterized by interstitial hemorrhage with associated neutrophilic inflammation and karorrhectic debris. While the finding is somewhat non-specific in etiology, it has been seen in cases of ANCA-associated glomerulonephritis, IgA nephropathy, and patients with prior infection treated with antibiotics (see reference). Reference: Hendricks AR, Harris AA, Walker PD, et al. Renal medullary angiitis: a case series from a single institution. Human Pathology (2013); (44): 521-525.  

Diagnose This (October 19, 2020)

Sarcoidosis, kidney biopsy stain, arkana laboratories, renal pathology
What would be your leading diagnosis in a patient with elevated ACE levels and hilar lymphadenopathy?      ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​...

Twitter Poll (October 14, 2020)

Exostosin, arkana laboratories, autoimmune diseases, renal pathology
Answer: D Exostosin is an antigen that was recently identified out of a cohort of Phospholipase A2 Receptor (PLA2R) and Thrombospondin Type-1 Domain-Containing 7A (THSD7A) negative cases of Membranous GN. Results showed that EXT1/2 positive cases were associated with autoimmune disease, including systemic lupus erythematosus (see reference).   Reference: Sethi S, Madden BJ, Debiec H, et al. Exostosin 1/Exostosin 2-Associated Membranous Nephropathy. J Am Soc Nephrol 2019; 30(6): 1123-1136.  

Diagnose This (October 5, 2020)

amyloidosis, AL-type, immunofluorescence in renal pathology, kidney biopsy, congo red stain, Arkana Laboratories
What is at the top of your differential in a patient with a positive SPEP (IgG kappa) and the immunofluorescence finding below? (hint: lambda is negative)     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​  ...

Diagnose This (September 21, 2020)

Endothelialitis, arkana laboratories, diagnose this, renal pathology, kidney pathology
What is this finding and what is the significance in the transplant setting?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​...