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November 30, 2021

Diagnose This (November 29, 2021)

What is your differential diagnosis for this ultrastructural finding?

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The EM picture shows subendothelial lucent widening and new glomerular basement membrane formation, in the absence of immune-type electron-dense deposits. This finding is indicative of chronic endothelial injury and can be seen in the setting of chronic thrombotic microangiopathy, antibody-mediated rejection, sickle cell nephropathy, among others.