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Renal Pathology 101
 
Calman Session
March 30th 2017
Case 1
A 34 yo female presented with lower limb swelling. Urine dip +++ protein, no blood. UPCR 450. Creatinine 77.
 
IF: IgA, IgG, IgM, C3, C1q, kappa and lambda are negative. 
 
EM: the findings displayed on the image were diffusely distributed. 
Case 1
Case 1
Case 1 x4200.jpg
Diagnosis & discussion [0]
Case 2

Female 54 years. Nephrotic syndrome. Normal renal function. Blood ++, protein +++. ANA mildly positive 1:40.

IF: Moderate to strong granular capillary loop staining for IgG and C3. IgA, IgM, C1q, kappa and lambda negative. Immunohistochemistry for PLA2R was performed (image).

Case 2
Case 2
Case 2 PLA2R .jpg
Diagnosis & discussion [0]
Case 3

A 45 year-old male presented with proteinuria and haematuria and mildly impaired eGFR.

IF: IgG and IgM are negative. C3 similar staining to IgA (image).

EM image provided.

Case 3
Case 3 IgA.jpg
Case 3 x3500.jpg
Diagnosis & discussion [0]
Case 4

A 17-year-old man presented with nephrotic syndrome and loss of eGFR.

IF/EM: IgG, IgA, IgM, C1q, Kappa and Lambda are negative. C3 and EM images are attached.

Case 4
Case 4
Case 4 C3.jpg
Case 4 EM.jpg
Diagnosis & discussion [0]
Case 5

82-year-old woman presented with tiredness, lethargy, nausea and AKI. Urine dip blood+++, protein+++.

IF: IgA, IgM, C3 and C1q were negative. Kappa and lambda were positive, with similar intensity. IgG image provided.
Case 5
Case 5 IgG 100x.jpg
Diagnosis & discussion [0]
Case 6

72-year-old man. T2DM; obese; rise in creatinine 90 to 160 µmol/L over 4 months; no proteinuria reported. 

IF: IgA, IgG, IgM, C3, C1q negative. Kappa and lambda staining of equal intensity.
 
EM image provided.
Case 6
Case 6
Case 6
Case 6 EM.jpg
Case 6 EM2.jpg
Diagnosis & discussion [0]
Case 7

Previously well 90-year-old lady. Creatinine 449 and worsening. Raised calcium – 2.61.

Case 7 H&E
Case 7 PAS
Diagnosis & discussion [0]
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