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Currently filtering by tag: Lambda

IgA nephropathy with something extra…

IgA nephropathy in renal biopsy from Arkana Laboratories
The biopsy is from a 61-year-old man with a history of intermittent microscopic hematuria for many years who presents with recent 18-pound weight loss and nephrotic syndrome.  His creatinine is mildly elevated at 1.3 mg/dL.  He has 12.5 g of proteinuria and his serum albumin is 2.6 mg/dL.  The biopsy shows diffuse mild mesangial matrix expansion with no necrosis or proliferative lesions (Fig. 1).  Immunofluorescence microscopy shows extensive granular mesangial IgA deposits (3+) (Fig. 2), compatible with IgA nephropathy.  Interestingly, the Jones methenamine silver stain also shows argyrophilic spikes involving capillary loops, which are most suggestive of spicular amyloid deposits...

Pushing Glass (September 7, 2017)

type 1 cryoglobulinemia, renal biopsy, kidney disease, arkana laboratories, pushing glass
The patient is a 75-year-old female who presents with proteinuria and a creatinine of 2.50. She has chronic lymphocytic leukemia, hypertension, and multiple sclerosis. What is the best diagnosis? A. Type I Cryoglobulinemia B. Type II Cryoglobulinemia C. Hepatitis C associated MPGN D. C3 Glomerulonephritis   The best answer is A (type 1 cryoglobulinemia). The biopsy shows a membranoproliferative pattern with IgG lambda restriction. The presence of hyaline thrombi is concerning for cryoglobulinemia. Cryoglobulins are immunoglobulins that precipitate in the cold and dissolve on warming and induce disease via vascular injury and blockage. Three types of cryoglobulins are distinguished based...

Diagnose This! (August 6, 2018)

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