#3 Zaman - Glomerular Diseases Flashcards
Child comes into your office and the mother says he is having problems seeing and he is not listening to her anymore. You evaluate his eyes and notice he has lens dislocation. What do you suspect?
Alport’s Syndrome - X-linked collagen IV defect
Alpha 5 skin staining is negative.
Identify disease if any.
Normal Glomerulus
Identify disease if any.
Minimal Change Disease
- foot process fusion
5 year old comes in with lower extremity edema, UA of 3+ protein and no hypertension. She responds to steroids within 8 weeks. What was your diagnosis?
Minimal Change Disease
(FSGS is not steroid responsive.)
A 56 year old African American male has non-selective proteinuria and was diagnosed with Focal Segmental Glomerulosclerosis. What is the likelihood that he will respond to steroids? What type of deposits will be seen and EM features?
Poor response
IgM and C3
Tubular atrophy (not a feature of MCD)
Adult comes in for evaluation. She is deposition of granular IgG adn C3 on the epithelial side of the membrane. What is he cause of this nephrotic syndrome?
Membranous GM
Identify the disease if any.
Membranous GN
Capillary loops are thick and prominent.
Mesangial cellularity is not increased.
Identify the disease if any.
Membranous GN
Silver Stain
Spikes - deposits filling space
Identify the disease if any.
Membranous GN
EM
Subepithelial deposits
spikes
Podocytes not attached
Identify the disease if any.
Diabetes mellitus
Nodules
Vascular basement membrane thickening
Mesangial hyperplasia
47 year old female comes in with persistent proteinuria, hypertension and progressive decline in renal function. What would you expect to see on microscopy?
Kimmelstein-Wilson Disease
Mesangial hyperplasia
Nodular glomerulosclerosis
(On fundus exam - microangiopathic changes)
Identify the disease if any.
Rapidly Progessing Glomerulonephritis (RPGN)
3 Types
Type I - linear, IgG
Type II - Granular
Type III - Pauci-immune, no dense deposits, C-ANCA
How would you treat Type I RPGN?
Plasmapheresis
How would you treat Type II RPGN?
Treat underlying disorder
How would you treat Type III RPGN?
Immunosuppressive regimens
Identify the disease if any.
Goodpastures
Type I RPGN
Linear IgG and C3
Identify the disease if any.
IgA Nephropathy
IgA deposits and C3
NO IgM
Identify the disease if any.
SLE
granular deposits
pink glomerulus
Wire Looping (Loopy Lupus)
Identify the disease if any.
MPGN Type 1
Tram-track
Hepatitis B & C
IgG and C3
nephrotic –> nephritic
(Military Police are on Tram Track #1)
Identify the disease if any.
MPGN Type II
Dense deposit disease
Decreased C3 serum due to C3 deposits in glomeruli
NO IgG
Identify the disease if any.
Fabry’s
Zebra bodies
Found in the endothelium.
Lysosomal storage disorder
Identify the disease if any.
Alport’s Syndrome
Thickening of the basement membrane
Lamination in a basket weave appearance
