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February 13, 2017

Diagnose This! (February 13, 2017)

Please pick the best answer.

These images show characteristic findings of which of the following diseases:

A) IgG4-Related Disease
B) Lupus Nephritis
C) Sjögren’s Syndrome-Related Tubulointerstitial Injury
D) Anti-Brush Border Antibody Tubulointerstitial Nephritis
E) Aristolochic Acid Nephropathy
F) Mesoamerican Nephropathy

Answer: D. Immune complex tubulointerstitial nephritis due to autoantibodies to the proximal tubule brush border is a recently described entity arising from IgG autoantibodies targeting the proximal tubule brush border. Associated immune complex deposits were also reported within the proximal tubule basement membranes and focal, segmental subepithelial space, reminiscent of early membranous glomerulopathy. Further reading: https://www.ncbi.nlm.nih.gov/pubmed/26334028