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Currently filtering by tag: Linear IgG

Anti GBM Disease

This biopsy from an 80-year-old male with acute kidney injury shows glomeruli with frequent rupture of the capillary loops and Bowman’s capsule, associated with fibrinoid necrosis of the glomerular tuft and cellular crescent formation (Fig 1). Of note, there are scattered multinucleated giant cells within the involved glomeruli. Immunofluorescence shows diffuse and global bright linear staining of the capillary loops for IgG (Fig 2), kappa and lambda. These findings are diagnostic of anti-glomerular basement membrane disease.  Multinucleated giant cells are significantly more common in anti-glomerular basement membrane disease when compared to ANCA-associated glomerulonephritis, and may serve as a marker of...

Pushing Glass (March 14, 2017)

The patient is a 61-year-old female who presents with hematuria and a creatinine of 6.23 mg/dL (baseline creatinine of 1.17 one month ago). What is the most likely diagnosis? A. Pauci-Immune Crescentic Glomerulonephritis B. Anti-Glomerular Basement Membrane Disease C. Crescentic Fibrillary Glomerulonephritis. D. Lupus Nephritis E. Early Diabetic Glomerulopathy The answer is B: The biopsy shows linear glomerular basement membrane staining for IgG, kappa, and lambda and this staining pattern is diagnostic of anti-glomerular basement membrane disease. Anti-glomerular basement membrane disease has a bimodal distribution in the general population. Younger patients (in their 20s) usually present with both hemoptysis and...