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Diagnose This! (August 14, 2017)

L. Nich Cossey, MD
By L. Nich Cossey, MD

Aug 14, 2017

thrombotic microangiopathy

An immunofluorescence panel for IgA, IgG, IgM, C3, C1q, kappa and lambda was negative. What is your diagnosis?

 

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The photomicrograph shows a high power image of a glomerulus on Jones silver stain. The glomerulus displays mesangiolysis and enlarged capillary loops often filled with congested red blood cells and frequent fibrin thrombi. While a somewhat similar glomerular appearance can be seen in cryoglobulinemia, in the presence of a negative immunofluorescence panel these findings are most consistent with thrombotic microangiopathy.

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