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Currently filtering by tag: Membranous lupus nephritis

Art of Medicine: Membranous Lupus Nephritis

The above painting depicts electron microscopy of two glomerular capillary loops and a mesangial region from a case of membranous lupus nephritis, showing intramembranous and mesangial electron-dense deposits.  An electron photomicrograph from a patient with membranous lupus nephritis, showing the same features, is also shown below. Pure membranous lupus nephritis (classified under the International Society of Nephrology / Renal Pathology Society system as class V), without an associated focal or diffuse (proliferative) lupus nephritis, occurs in approximately 15 percent of all patients with renal involvement by systemic lupus erythematosus (SLE).   This percentage is higher in African Americans with SLE.   While...

Diagnose This! (November 27, 2017)

What is your diagnosis (IgG stain shown)?     ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​  ...

Vascular Staining in Membranous

This immunofluorescence (IF) image shows extensive granular glomerular capillary wall IgG deposits, consistent with membranous glomerulopathy. The glomerular staining pattern as seen by IF is not specific for either primary or secondary membranous glomerulopathy. However, the prominent IgG deposits also involving the associated arteriole in this case are an important clue that helps argue for a secondary etiology. This patient, in fact, was found to have systemic lupus erythematosus.

Subepithelial Deposits in Lupus Nephritis

According to the ISN/RPS 2003 classification of lupus nephritis, membranous lupus nephritis (class V) is characterized by the presence of global or segmental subepithelial immune deposits with or without associated mesangial deposits or mesangial hypercellularity. Membranous lupus nephritis may occur in isolation or may coexist with other forms of active lupus nephritis such as focal (class III) or diffuse (class IV) lupus nephritis. In the presence of active glomerular lesions, scattered subepithelial deposits are common and are not diagnostic of membranous lupus nephritis (class V). In fact, in order to make a diagnosis of membranous lupus nephritis (class V) in...

Diagnose This! (June 26, 2017)

What’s your diagnosis?     ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​   ​   ​ ​...