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Currently filtering by tag: C3 glomerulonephritis

Twitter Poll (July 10, 2019)

Membranoproliferative GN, monoclonal gammopathy, arkana laboratories, twitter poll, renal pathology
Answer: True About 5-10% of the patients with monoclonal gammopathy and findings consistent with C3GN by standard IF (on frozen tissue) will actually have a Membranoproliferative GN with masked monoclonal deposits. These patients require additional IF studies to be performed on protease-digested, paraffin-embedded tissue for identification of the monoclonal immunoglobulin in the deposits. References: Leung N, et al. The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group. Nat Rev Nephrol 2019; 15(1): 45-59. Larsen CP, et al. Membranoproliferative glomerulonephritis with masked monotypic immunoglobulin deposits. Kidney Int 2015; 88(4): 867-873....

Disease Week: C3 Glomerulonephritis

C3 Glomerulonephritis, Arkana Laboratories, Disease Week, renal disease, kidney pathology
Monday Rediscovery of Complement Mesangial C3 deposition only within the glomerulus has been reported since 1980. Only recognized recently as a distinct entity when CFHR5 nephropathy was reported. CFHR5 mutation is speculated to represent a founder mutation which can be traced back to the Troodos mountains of Cyprus. https://www.ncbi.nlm.nih.gov/pubmed/21566112   1 in 6500 people in Cyrus carry a mutation in CFHR5 (duplication of exons 2 and 3) and inheritance is autosomal dominant. C3 and C4 complement levels are normal. 80% of males with CFHR5 nephropathy progress to ESRD while only 20% of females progress to ESRD. https://www.ncbi.nlm.nih.gov/pubmed/22065842 CFHR5 nephropathy is...

Infection-Associated Glomerulonephritis

Infection-Associated Glomerulonephritis
A 60-year-old male presents with a painful left hip, hematuria, and a creatinine of 1.5 mg/dl. He was recently hospitalized due to fever and chills. It was found that his left hip implant was infected. Blood cultures grew out methicillin-resistant Staphylococcus aureus. After beginning treatment with antibiotics and planning for surgery, a nephrology consult was requested. A kidney biopsy was performed and serologies were ordered. Figure 1 shows segmental endocapillary hypercellularity. Figure 2 shows mild interstitial fibrosis. Figure 3 shows staining with C3 only. All other immunofluorescence stains were negative on the frozen tissue. Immunofluorescence was then performed on the...

Subepithelial Humps

The depicted electron micrograph shows numerous, large and irregular subepithelial deposits which protrude from the glomerular basement membrane towards the urinary space. The deposits are overlaid by significant epithelial foot process effacement and they lack definitive substructure. This type of deposits has historically been described as “hump-like”. While they are most commonly seen in the setting of infection-associated glomerulonephritis, they are by no means specific, and may be seen in other entities, such as C3 glomerulonephritis. When scarce, these deposits may be limited to the hinge region of the glomerulus. Over time, subepithelial hump-like deposits may become electron-lucent and eventually...

Pushing Glass (May 16, 2017)

A 15-year-old boy had a kidney biopsy because of the persistent nephrotic syndrome. His medical history is significant for resolved intermittent asthma. In late September 2016, he developed a viral syndrome with a runny nose, congestion, sore throat, vomiting, and diarrhea. Over the next one to two weeks, he developed generalized edema, most prominent in the lower extremities and belly. He was diagnosed presumptively with acute glomerulonephritis and treated accordingly. His condition continued to worsen with the persistent nephrotic syndrome and acute hypertension. Laboratory investigations show a serum creatinine of 1.35 mg/dL. Serum albumin is 1.9 g/dL. Urinalysis shows 3+...