Back to Blog

Pushing Glass (March 22, 2017)

Md Shahrier Amin, MD
By Md Shahrier Amin, MD

Mar 22, 2017

Cryoglobulinemic glomerulonephritis

A 71-year-old woman with a history of multiple myeloma, hypertension and vitamin D deficiency presented with decreased renal function. Investigations show serum creatinine increased to 3.36 mg/dL. Serum albumin is 2.6 gm/dL. Twenty-four hour urinary protein is 2.8 gm/day.

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

A) Thrombotic microangiopathy
B) Cast nephropathy
C) Light chain deposition disease
D) Cryoglobulinemic glomerulonephritis
E) Amyloidosis
F) Fibrillary glomerulopathy

Answer: D

The images show intracapillary hyaline, thrombi which are weakly PAS-positive, and stain red on silver and trichrome stains. These showed positive staining only for IgG1 and kappa light chain. The capillary loops are substantially thickened by predominantly subendothelial and para-mesangial electron dense deposits. Congo red stain is negative. The features are indicative of type I cryoglobulinemic glomerulonephritis, as can be seen in patients with a monoclonal immunoglobulin precipitation or an underlying B cell lymphoproliferative disease. For further reading: https://www.ncbi.nlm.nih.gov/pubmed/23429354

 

Tags:

Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.