arrow-right-realarrow-right-whitearrow-rightback-to-topdoctordownloadfacebookinstagramlogo-markerlogo-wordmarkpodcastsearchsearch_whitetwitter
Close Modal

Blog


Currently filtering by tag: Fibrin thrombi

Endocapillary Hypercellularity in Thrombotic Microangiopathy

This renal biopsy performed on a 14-year-old boy shows changes diagnostic of a thrombotic microangiopathy (TMA). These changes include frequent fibrin thrombi within the arteriolar lumens and glomerular hilum, endothelial swelling, mesangiolysis and focal glomerular ischemic changes (Fig 1-3). Of note, the glomeruli frequently show marked global endocapillary hypercellularity, mostly composed of swollen endothelial cells and occasional circulating inflammatory cells (Fig 4). Immunofluorescence and electron microscopy show absence of immune complex deposition (not shown). This case illustrates that a subset of cases of TMA may show endocapillary hypercellularity and is important to avoid misdiagnosing such cases as a proliferative glomerulonephritis....

Antiphospholipid Antibody Syndrome

This biopsy shows glomerular arteriolar and capillary thrombi characteristic of thrombotic microangiopathy (TMA). Immunofluorescence studies (not shown) are negative for significant glomerular or tubulointerstitial immune complex deposits. The clinical history corresponding to such findings might involve an adult female patient with a history of rheumatoid arthritis and multiple miscarriages who presents with non-nephrotic range proteinuria, microscopic hematuria, hypertension, and no mental status changes. Laboratory workup could show thrombocytopenia, elevated LDH, low haptoglobin, and a positive lupus anticoagulant, and imaging studies might confirm findings of systemic thrombosis. A clinical diagnosis of antiphospholipid antibody syndrome related to underlying autoimmune disease (rheumatoid arthritis)...

Diagnose This! (August 14, 2017)

An immunofluorescence panel for IgA, IgG, IgM, C3, C1q, kappa and lambda was negative. What is your diagnosis?     ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​...

Diagnose This! (April 3, 2017)

What is your diagnosis?     ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​   ​   ​...