Case 1: Additional Pathology

Case 1 Index

Finally, some additional slide preparations are ready! Take a look into the microscope below…

PAS (Periodic Acid Schiff)
Acute Proliferative Glomerulonephritis on PAS

EM (Electron Microscopy)

Infection-Associated Subepithelial Hump Formation

Which of the following do you see above?
Subepithelial hump-like deposits
Correct! Subepithelial deposits are seen closer to the podocyte (also known as the visceral epithelial cell). Here, they appear large and have a hump-like appearance, and reside under the podocyte foot processes. The podocyte also appears effaced or flattened.
Subendothelial deposits
There are definitely deposits here, but subendothelial deposits would be in the basement membrane closer to the endothelial cells. The deposits we see her appear under the podocyte. You’re close, take another shot!
Duplication or “tram-tracking” of the basement membrane
The basement membrane appears to be intact here, with only one layer visible. Try again!
Mesangial deposits
We see deposits in this EM image, but they don’t appear to be in the mesangial space, or the space between the capillary loops. Pick again!

IF (Immunofluorescence)

C3
Granular, Glomerular C3 Deposition

IgG
Granular, Glomerular IgG Deposits

It’s time to lock in your final diagnosis! Choose one before moving on to the end of this case.
Post-infectious glomerulonephritis (PIGN)
Membranous nephropathy
Diabetic nephropathy
Acute interstitial nephritis (AIN)
Systemic lupus erythematosus (SLE) nephritis
Anti-glomerular basement membrane (GBM) disease
Acute tubular necrosis (ATN)
IgA nephropathy
Hypovolemia

Click here when you’re confident in your final diagnosis!

Case 1 Index
Case 1 Introduction
Case 1 Physical Exam
Case 1 Diagnostic Testing
Case 1 Pathology