Case 8: Additional Pathology

Case 8 Index

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

EM (Electron Microscopy)
Diffuse Foot Process Effacement.jpg

Which of the following do you see above?
Subepithelial hump-like deposits
We don’t see any deposits in the basement membrane here, try again!
Subendothelial deposits
 We don’t see any deposits in the basement membrane here, try again!
Duplication or “tram-tracking” of the basement membrane
The basement membrane appears to be intact here, with only one layer visible. Try again!
Podocyte effacement
Excellent! We see diffuse podocyte effacement here.
Which of the following would you be most likely to see on immunofluorescence (IF) for this patient?
Granular basement membrane staining of IgG
We don’t see any deposits on EM, so we would not expect to find granular IF staining of the basement membrane.
“Full house” staining
“Full house” staining refers to granular basement membrane/mesangial staining of IgG, IgA, IgM, C3, and C1q – typically seen in SLE nephritis and is accompanied by deposits seen under EM.
Negative IF
Great! There are no dense deposits seen on EM, so the IF is likely to be negative.
Mesangial staining of IgA
We don’t see mesangial deposits on EM, so we would not expect to see IF staining for IgA in the mesangium.
It’s time to lock in your final diagnosis! Choose one before moving on to the end of this case.
Membranous nephropathy
Henoch-Schonlein purpura
Focal segmental glomerulosclerosis
Acute interstitial nephritis (AIN)
Sickle cell nephropathy
Systemic lupus erythematosus (SLE) nephritis
Minimal change disease
Acute tubular necrosis (ATN)
IgA nephropathy
Hepatitis C-related glomerulonerphritis
Post-infectious glomerulonephritis

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

Case 8 Index
Case 8 Introduction
Case 8 Physical Exam
Case 8 Diagnostic Testing
Case 8 Pathology