How to classify nephrotic syndrome?
Classification of nephrotic syndrome is based on the pattern of injury as seen on light microscopy (LM) of a renal biopsy specimen. For a complete assessment, all biopsy specimens should be analyzed using LM, immunofluorescence microscopy (IM), and electron microscopy (EM).
What are findings in minimal change disease?
EM: effacement of the foot processes of podocytes
LM: no changes in glomeruli (possibly fat bodies in some proximal tubular cells)
What are findings of focal segmental glomerulosclerosis?
damage to podocytes
EM: effacement of the foot processes (similar to minimal change disease)
LM: segmental sclerosis and hyalinosis and loss of podocytes
IM: rarely, focal deposits of IgM, C1, and C3 inside sclerotic lesion
What are findings of membranous nephropathy?
deposition of antibodies between podocytes and the basal membrane
EM: subepithelial dense deposits (IgG and C3) with a spike and dome appearance
LM: diffuse thickening of glomerular capillary loops and basal membrane
IM: granular subepithelial deposits of immune complexes and complement
What are findings of diabetic glomerulonephropathy?
light microscopy shows mesangial matrix expansion, thickening of glomerular membrane, and/or nodular eosinophilic glomerulosclerosis (Kimmelstiel-Wilson lesions)
What are findings of lupus nephritis?
light microscopy shows mesangial proliferation, subendothelial and/or subepithelial immune complex deposition, and thickening of the capillary walls (appear as wire loops)
What are findings of amyloid nephropathy?
EM: amyloid fibrils
LM
Nodular glomerulosclerosis
Apple-green birefringence (mesangial amyloid deposition) with Congo red stain under polarized light
Zuletzt geändertvor 2 Jahren