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Diagnose This! (January 29, 2018)

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

Jan 29, 2018

Thrombotic Microangiopathy
Camera information: Calibration= 1.000 Pixels per pixel; Capture format= 1392 x 1040, Full Frame HQ; Gamma= 0.99; Gain= 1.0 x; Exposure= 32.6 ms; Auto exposure= On; Image type= Colour; Shading= LM; Sharpening= Low; Black clip= 0; White clip= 236; Microscope information:

What is your diagnosis? Immunofluorescence is negative.

 

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The photomicrograph shows a high power image of a glomerulus on H&E stain. The glomerulus displays extensive mesangiolysis and focal capillary loops congested with red blood cells. Of note, numerous red blood cell fragments are present throughout the mesangiolytic portions of the glomerulus and within the capillary walls. In the presence of a negative immunofluorescence panel these findings are most consistent with thrombotic microangiopathy.

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