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Currently filtering by tag: Fibrinoid necrosis

Twitter Poll (December 11, 2019)

Anti-GBM disease, twitter poll, arkana laboratories
Answer: D Anti-GBM disease presents with rapidly progressive glomerulonephritis (GN) with or without pulmonary hemorrhage. On biopsy typical disease displays bright polytypic linear GBM staining for IgG by immunofluorescence and diffuse crescentic/necrotizing GN on light microscopy. Anti-glomerular basement membrane (GBM) nephritis is clinically and pathologically one of the most aggressive form of glomerulonephritis. Patients typically present with nephritic syndrome and rapidly progressive acute kidney injury. Lung involvement in the form of alveolar hemorrhage occurs in 34% to 62% of patients. Anti-GBM disease is due to circulating autoantibodies directed against cryptic epitopes in the NC1 domain of the alpha-3 chain of...

Crescentic IgA nephropathy

IgA, Crescentic IgA Nephropathy, chronic kidney disease, Arkana Laboratories
The patient is a 17-year-old white female who presents with 2.85 grams/24 hr proteinuria, microscopic hematuria, and a creatinine of 3.2 mg/dl. She was in her normal state of health and was incidentally found to have abnormal lab values and urinalysis at a routine sport's physical. She reports that she had noticed a little more fatigue the last few months, but had blamed this on being busy at her job after school. Figure 1 shows focal fibrinoid necrosis. Figure 2 shows moderate tubular atrophy and interstitial fibrosis. Figures 3 & 4 show a segmental cellular crescent. Figure 5 shows several...

Diagnose This (August 20, 2018)

ANCA-Mediated Vasculitis
What is your presumed diagnosis in the absence of immunofluorescence and electron microscopy?   ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​...

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...

Diagnose This (June 18, 2018)

ANCA-mediated disease
In the presence of a negative immunofluorescence panel, what is your diagnosis?   ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​...

Evaluating Eosin-Stained Frozen Section Slides Using Fluorescence Microscopy

fluorescence microscopy
As published decades ago by Bonsib et al. (see reference), fluorescence microscopy of eosin-stained frozen section slides can be a valuable tool in providing diagnostic clues in kidney biopsies.  The fluorescent properties of eosin dye allow for nice visualization of glomerular capillary and larger vascular basement membranes.  Consequently, various disease processes which disrupt these structures can often be detected using eosin-stained frozen section slides.  The presence of glomerular fibrin, for example, is easy to recognize using this method (see the image showing fibrinogen staining), and indicates a disease process causing glomerular capillary rupture, such as ANCA-related or immune complex-mediated glomerulonephritis. ...