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UK National Renal Pathology EQA Scheme

Circulation U 
 
Prof. Ian Roberts 
U1
10 year old female presented with chronic idiopathic thrombocytopenic purpura. Deafness. Haematuria and proteinuria. 
Slides: H&E, PAS, Jones, MT.
5 EM images.
U1-H&E
U1-PAS
U1-Jones
U1-MT
U1 2000x.jpg
U1 3000x.jpg
U1 5000x.jpg
U1 6000x.jpg
U1 6000x-2.jpg
Diagnosis & discussion [0]
U2
47 year old female admitted in July with accelerated raised blood pressure. Creatinine 226. EGFR 22. PCR 360. Negative immunology, evidence of retinopathy and left ventricular hypertrophy (end organ damage).
Slides: H&E, PAS, Jones, EVG.
IH: IgA.
U2-H&E
U2-PAS
U2-Jones
U2-EVG
U2-IgA
Diagnosis & discussion [0]
U3
46 year old male. Creatinine 150 umol/L. Proteinuria 2.28g/24h. Microscopic haematuria. Urological investigations negative.
Slides: H&E, PAS, Jones, Congo red.
IF: IgG and C3.
3 EM images.
U3-H&E
U3-PAS
U3-Jones
U3-Congo red
U3 - IgG.jpg
U3 - C3.jpg
U3 - EM1.jpg
U3 - EM2.jpg
U3 - EM3.jpg
Diagnosis & discussion [0]
U4
82 year old man presented with nephrotic syndrome. Not diabetic. Urea 21.6. Creatinine 722.
Slides: H&E, PAS, Jones and Congo red.
IF findings: Faint staining for IgM and C3. All others negative (IgA, IgG, C1q, kappa and lambda).
4 EM images.
U4-H&E
U4-PAS
U4-Jones
U4-Congo red
U4 - 6700x.jpg
U4 - 8000x.jpg
U4 - 10000x.jpg
U4 - 27000x.jpg
Diagnosis & discussion [0]
U5
40 year old female with bilateral acute anterior uveitis which recurred following cessation of topical steroid treatment. No other past medical history. 
IF findings: negative.
EM: not performed. 
U5-H&E
U5-PAS
Diagnosis & discussion [0]
U6
61 year old male . AKI. Creatinine 80 to 130 in the last 4/52. Dip: +++ blood ++++ protein. UPCR 130. PR3 132. 
Slides: H&E, PAS, Jones, MSB. 
IF findings: Non-specific focal trapping of C3. No specific deposition of IgG, IgA, C1, kappa or lambda. 
U6-H&E
U6-PAS
U6-Jones
U6-MSB
Diagnosis & discussion [0]
U7
69 year old male. AKI on a background of CKD. Hypercalcemia. Serum ACE negative.
Slides: H&E and Jones.
Special stains findings: ZN and PASD negative. 
IF findings: IgA, IgG, IgM, C3 and C1q negative.  
U7-H&E
U7-Jones
Diagnosis & discussion [0]
U8
27 year old male. T1DM for 15 years. Retinopathy. Hypertension. 3g proteinuria 2 years ago. Now nephrotic; proteinuria 10g/day, albumin 28. Creatinine 228. 
Slides: H&E and PAS. 
IF findings: linear deposition of IgG along basement membranes. Focal IgM and C3 at arteriolar hyaline lesions. 
U8-H&E
U8-PAS
Diagnosis & discussion [0]
U9
71 year old female. Multifocal lesions on brain MRI + confusion. Proteinuria and blood in urine. MPO and PR3 negative. Anti-GBM negative. Heterogeneous kidney on CT scan. ? vasculitis.
Slides: H&E 
IF findings: IgA, IgG, IgM, C3, C1q, kappa and lambda negative.  
U9-H&E
Diagnosis & discussion [0]
U10
8 year old female. Rapidly progressive glomerulonephritis. Complement and antibodies awaited. 
Slides: H&E and PAS.
IH: C3.
4 EM images. 
U10-H&E
U10-PAS
U10-C3
U10 EM1 x6000.jpg
U10 EM2 x6000.jpg
U10 EM3 x6000.jpg
U10 EM4 x6000.jpg
Diagnosis & discussion [0]
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