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August 14, 2017
Diagnose This! (August 14, 2017)

- Published: August 14, 2017
- By: L. Nich Cossey, MD and Arkana Author
- Tags: Acute kidney injury, Fibrin thrombi, Fragmented RBCs, Hematuria, Proteinuria, Thrombotic microangiopathy, TMA
An immunofluorescence panel for IgA, IgG, IgM, C3, C1q, kappa and lambda was negative. What is your diagnosis?
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.