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Currently filtering by tag: Crescentic glomerulonephritis

Disease Week: Bacterial infection-associated glomerulonephritis and endocarditis-associated glomerulonephritis

Monday Renal disease related to infective endocarditis was first reported over 100 years ago. However, the initial literature describing nephritis associated with infective endocarditis relied primarily on autopsy-based studies from the pre- and early post-antibiotic era.  Reviews from recent decades note the evolution in renal complications of infectious diseases. Demographics have changed from younger to older patients. The frequency of comorbidities including diabetes has increased.  Recent decades have seen a change in the infectious agents that cause renal disease, from primarily Streptococcal to a broader array of organisms compared to the past, with predominance of Staphylococci. The historical division into...

Twitter Poll (August 22, 2018)

Anti-GBM in renal biopsy at Arkana Laboratories
ANSWER: D Anti-GBM disease is a rare small vessel vasculitis that affects glomerular and pulmonary capillaries. The majority of patients develop widespread glomerular crescent formation, presenting with features of rapidly progressive GN, and 40-60% will have concurrent alveolar hemorrhage

Digging Deeper, Literally

ANCA Disease, LECT2 Amyloid, IgG4-Related Disease, AL amyloidosis, ANCA, digging deeper, Dr. Messias, Arkana Laboratories, pathology diseases
This biopsy came from a 79-year-old patient. He had presented with acute renal failure. His serum creatinine was up to 2.0 mg/dL, from a normal baseline. He also had proteinuria, which was quantified as approximately 1 g. His serum albumin was low at 2.5 g/dL. The patient was anemic, and hemoglobin was 9.1. The patient had been investigated with an extensive serologic work up. ANA was negative, C3 was within normal limits, and SPEP was negative for monoclonal proteins. However, ANCA serologies were positive. Based on that, the patient had been treated with high doses of steroids for a few...

Hidden Treasures

ANCA Disease, LECT2 Amyloid, IgG4-Related Disease, AL amyloidosis, ANCA, digging deeper, Dr. Messias, Arkana Laboratories, pathology diseases
This biopsy came to us due to acute renal failure and proteinuria. The patient was a gentleman in his late 70s, with elevated creatinine up to 2.0 mg/dl, and proteinuria quantified at about 1 gram per 24 hours. His serum albumin was remarkably low, at 2.5 g/dL. He was also anemic, with hemoglobin at 9.1 g/dL. ANCA serologies were positive and the patient had been treated with high doses of steroids for a few weeks prior to the biopsy. SPEP was negative for monoclonal proteins. ANA serology was negative. Fortunately for us, the biopsy was a great sample of renal...

Crescentic Glomerulonephritis with IgA Deposits

Crescentic Glomerulonephritis with IgA Deposits
This biopsy was taken from a 58-year-old male with no significant past medical history, who presents with gross hematuria, serum creatinine of 2.5 mg/dl and a urine protein/creatinine ratio of 1.4 g/g. The biopsy shows segmental rupture of the capillary loops associated with fibrinoid necrosis of the glomerular tuft and cellular crescent formation (Fig 1 – Jones stain). Of note, no mesangial or endocapillary proliferation is present. Immunofluorescence (Fig 2) shows mesangial granular staining for IgA (3+), C3 (1+), kappa (2+) and lambda (3+). Electron microscopy (not shown) shows scattered mesangial electron-dense deposits. The differential diagnosis in patients with necrotizing and...