Difference between revisions of "IPLab:Lab 6:Glomerulonephritis"
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== Clinical Summary == | == Clinical Summary == | ||
| − | This | + | This 27-year-old male had end-stage renal disease requiring hemodialysis for 10 years. For the previous four years he had hypertension which slowly increased to about 180/120 mm Hg. Laboratory findings included a markedly elevated BUN and creatinine. He underwent bilateral nephrectomy and was placed on the transplant list. |
| − | + | On examination the kidneys were similar in appearance. Cortices were pale, diffusely granular with a few 1-2 mm cysts. On being sectioned, the cortex of each kidney was thin (4-5 mm) and pale. Renal medullae were pale yellow-tan in color and there was abundant peripelvic fat. The ureters, pelvis, calyces and hilar vessels showed no abnormalities. | |
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== Images == | == Images == | ||
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File:IPLab6GN10.jpg|For comparison this is an immunofluorescent photomicrograph of a glomerulus from a patient with Goodpasture's syndrome. The linear (arrows) immunofluorescence is characteristic of Goodpasture's syndrome. | File:IPLab6GN10.jpg|For comparison this is an immunofluorescent photomicrograph of a glomerulus from a patient with Goodpasture's syndrome. The linear (arrows) immunofluorescence is characteristic of Goodpasture's syndrome. | ||
</gallery> | </gallery> | ||
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| + | == Virtual Microscopy == | ||
| + | <peir-vm>IPLab6GN</peir-vm> | ||
== Study Questions == | == Study Questions == | ||
Latest revision as of 23:40, 8 July 2020
Contents
Clinical Summary[edit]
This 27-year-old male had end-stage renal disease requiring hemodialysis for 10 years. For the previous four years he had hypertension which slowly increased to about 180/120 mm Hg. Laboratory findings included a markedly elevated BUN and creatinine. He underwent bilateral nephrectomy and was placed on the transplant list.
On examination the kidneys were similar in appearance. Cortices were pale, diffusely granular with a few 1-2 mm cysts. On being sectioned, the cortex of each kidney was thin (4-5 mm) and pale. Renal medullae were pale yellow-tan in color and there was abundant peripelvic fat. The ureters, pelvis, calyces and hilar vessels showed no abnormalities.
Images[edit]
This is a low-power photomicrograph of a saggital section of end stage chronic glomerulonephritis (GN). Note the marked thinning of the cortex (arrow).
This is a higher-power photomicrograph of hyalinized glomeruli (arrows) and glomeruli with thick basement membranes.
This is a higher-power photomicrograph of hyalinized glomeruli (1) and glomeruli with thickened basement membranes (2).
This is a photomicrograph of interstitial and vascular lesions in end stage renal disease.
This is an immunofluorescent photomicrograph of granular membranous immunofluorescence (immune complex disease). The antibody used for these studies was specific for IgG.
This is an electron micrograph of subepithelial granular electron dense deposits (arrows) which correspond to the granular immunofluorescence seen in the previous image.
This is a photomicrograph of a glomerulus from another case with acute poststreptococcal glomerulonephritis. In this case the immune complex glomerular disease is ongoing with necrosis and accumulation of neutrophils in the glomerulus.
This immunofluorescent photomicrograph of a glomerulus from a case of acute poststreptococcal glomerulonephritis shows a granular immunofluorescence pattern consistent with immune complex disease. The primary antibody used for this staining was specific for IgG; however antibodies for complement would show a similar pattern.
This electron micrograph demonstrates scattered subepithelial dense deposits (arrows) and a polymorphonuclear leukocyte in the lumen.
For comparison this is an immunofluorescent photomicrograph of a glomerulus from a patient with Goodpasture's syndrome. The linear (arrows) immunofluorescence is characteristic of Goodpasture's syndrome.
Virtual Microscopy[edit]
Study Questions[edit]
Additional Resources[edit]
Reference[edit]
- eMedicine Medical Library: Assessment and Management of the Renal Transplant Patient
- eMedicine Medical Library: Poststreptococcal Glomerulonephritis
- Merck Manual: Nephritic Syndrome
- Merck Manual: Chronic Kidney Disease
- Merck Manual: Hemodialysis
- Merck Manual: Kidney Transplantation
Journal Articles[edit]
- Lan HY, Yang N, Nikolic-Paterson DJ, Yu XQ, Mu W, Isbel NM, Metz CN, Bucala R, Atkins RC. Expression of macrophage migration inhibitory factor in human glomerulonephritis. Kidney Int 2000 Feb;57(2):499-509.
Images[edit]
Related IPLab Cases[edit]
A normal alkaline phosphatase is 39 to 117 U/L.
These tests are measures of kidney function. High levels mean low function.
Oliguria is the occurrence of decreased urine output.
Hematuria is the presence of blood in the urine.
