Case Presentation Turki Al-Hussain, MD
|
|
- Justina Long
- 5 years ago
- Views:
Transcription
1 Case Presentation Turki Al-Hussain, MD Director, Renal Pathology Chapter Saudi Society of Nephrology & Transplantation Consultant Nephropathologist & Urological Pathologist Department of Pathology & Laboratory Medicine King Faisal Specialist Hospital & Research Centre 1
2 Clinical History An 8 year-old boy presented with vomiting and dark urine H/O sore throat H/O deftness in two of his cousins Family history of renal disease Physical examination: Temperature: 36.6 C, respiratory rate: 22/MIN, blood pressure: 106/70 mmhg and heart rate: 128/MIN Urine dipstick: RBC 3+, protein 2+ 2
3 Laboratory Data Urinalysis: 3+ blood, 3+ protein, 5-10 WBC/HPF, numerous RBC with RBC cast. Urine culture: no growth. ANA, canca, panca: Normal Throat culture: Negative Serum creatinine: 701 μmol/l (baseline 39) HIGH Complements: C3: 0.11g/l (n ) LOW C4: 0.26 g/l (n ) 3
4 Rapidly Progressive Glomerulonephritis 4
5 Renal Biopsy was Performed 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 Acute Diffuse Proliferative Glomerulonephritis with 50% Cellular Crescents 18
19 Differential Diagnosis Acute postinfectious glomerulonephritis Membranoproliferative glomerulonephritis type 1 Dense deposit disease (C3 glomerulopathy) Lupus nephritis IgA nephropathy 19
20 MPGN type 1 IgG C3 20
21 Dense deposit disease C3 21
22 Lupus nephritis Ig & C 22
23 IgA nephropathy IgA 23
24 Immunofluorescene IgG IgA IgM C1q Fibrinogen Kappa light chain Lambda light chain ALL NEGATIVE 24
25 IF: C3 25
26 IF: C3 26
27 ??? C3 Glomerulopathy 27
28 EM 28
29 EM 29
30 EM 30
31 EM 31
32 EM 32
33 Additional Laboratory Data: HIGH Anti-streptolysin O (ASO) titer: 454 IU (normal < 200 IU) 33
34 Final Diagnosis Acute Postinfectious Glomerulonephritis with 50% Cellular Crescents 34
35 Should IgG always present in acute postinfectious glomerulonephritis? No Some cases may have only C3 35
36 Follow up Peritoneal Dialysis IV Augmentin Pulse methylprednisolone for five days and then was switched to oral prednisolone 45 mg O.D, then tapered down. On discharge serum creatinine became 34 μmol/l C3 became normal after 1.5 month: 1.35 g/l(n ) 36
37 C3 Glomerulopathy A disease process due to abnormal control of complement activation, deposition, or degradation and characterized by predominant glomerular C3 fragment deposition with electron-dense deposits on EM. Based on EM appearances, it is divided into: 1- Dense Deposit Disease (DDD) 2- C3 Glomerulonephritis (C3GN) 37
38 The evolving classification of MPGN D'Agati VD et al. C3 glomerulopathy: what's in a name? Kidney Int ;82:
39 Why C3 Glomerulopathy was introduced? 1. The glomerular pathology associated with isolated C3 accumulation is far more heterogeneous than previously appreciated. 2. Advances in our understanding of complement-mediated kidney injury have made it possible to identify the cause of renal disease through specific complement investigations. 3. The existence of a licensed complement inhibitor (eculizumab) together with the many complement inhibitors in clinical development, so patients most likely will benefit from an anti-complement therapeutic approach. 39
40 C3 Glomerulopathy Glomerulonephritis with dominant C3 should be used as a morphological term for those cases with dominant staining for C3c. Dominant is defined as C3c intensity 2 orders of magnitude more than any other immune reactant on a scale of 0 to 3 (including 0, trace, 1+, 2+, 3+). 40
41 Pickering MC et al: C3 glomerulopathy: consensus report. Kidney Int. 2013; 84:
42 Gale DP, Pickering MC. Regulating complement in the kidney: insights from CFHR5 nephropathy. Dis Model Mech. 2011; 4:
43 Light Microscopic Features Mesangial proliferative Membranoproliferative Endocapillary proliferative Crescents may also be present In rare cases, glomeruli may be normal by LM 43
44 44
45 Postinfectious GN The differentiation of true PIGN from C3 glomerulonephritis often cannot be made on the basis of morphology and clinical and laboratory data available at the time of biopsy. According to the recommendations, a PIGN patient s biopsy may be read as glomerulonephritis with dominant C3 (infection-associated). However, this does not mean that the patient has C3 glomerulopathy. 45
46 Postinfectious GN In these cases, refining the differential diagnosis will require following the patient clinically and serologically over several months to determine the course of urinary abnormalities and serum C3 levels. If these parameters do not follow a typical course of PIGN (i.e., normalization of the decreased peripheral C3 level in 8 12 weeks), a diagnosis of C3 glomerulopathy should be reconsidered and additional investigations performed. 46
47 Pickering MC et al: C3 glomerulopathy: consensus report. Kidney Int. 2013; 84:
48 Patients with DDD were younger, more likely to have low serum C3 levels, and more likely to have crescentic GN than patients with C3GN. Patients with C3GN were older and had more severe arteriolar sclerosis, glomerular sclerosis, and interstitial scarring on renal biopsy than patients with DDD. Older age, crescentic GN, and DDD subtype were independent predictors of ESRD. Renal impairment at the time of renal biopsy predicted a poor prognosis only in patients with DDD. 48
49 Acknowledgment Dr. Fayzeh Mansour ( Pediatric Nephrologist at Security Forces Hospital) 49
50 References 1. Pickering MC et al: C3 glomerulopathy: consensus report. Kidney Int. 2013; 84: Medjeral-Thomas NR et al: C3 glomerulopathy: clinicopathologic features and predictors of outcome. Clin J Am Soc Nephrol. 2014;9: Hou J et al: Toward a working definition of C3 glomerulopathy by immunofluorescence. Kidney Int Sep 25. [Epub ahead of print] 4. Barbour TD, Pickering MC, Cook HT. Recent insights into C3 glomerulopathy. Nephrol Dial Transplant. 2013;28: D'Agati VD, Bomback AS. C3 glomerulopathy: what's in a name? Kidney Int. 2012; 82: Gale DP, Pickering MC. Regulating complement in the kidney: insights from CFHR5 nephropathy. Dis Model Mech. 2011; 4:
51 THANK YOU 51
Case Presentation Turki Al-Hussain, MD
Case Presentation Turki Al-Hussain, MD Director, Renal Pathology Chapter Saudi Society of Nephrology & Transplantation Consultant Nephropathologist & Urological Pathologist Department of Pathology & Laboratory
More informationPathology of Complement Mediated Renal Disease
Pathology of Complement Mediated Renal Disease Mariam Priya Alexander, MD Associate Professor of Pathology GN Symposium Hong Kong Society of Nephrology July 8 th, 2017 2017 MFMER slide-1 The complement
More informationC3 GLOMERULOPATHIES. Budapest Nephrology School Zoltan Laszik
C3 GLOMERULOPATHIES Budapest Nephrology School 8.30.2018. Zoltan Laszik 1 Learning Objectives Familiarize with the pathogenetic mechanisms of glomerular diseases Learn the pathologic landscape and clinical
More informationMayo Clinic/ RPS Consensus Report on Classification, Diagnosis, and Reporting of Glomerulonephritis
Mayo Clinic/ RPS Consensus Report on Classification, Diagnosis, and Reporting of Glomerulonephritis Sanjeev Sethi, MD, PhD Department of Laboratory Medicine and Pathology Disclosure Relevant Financial
More informationC3G An Update What is C3 Glomerulopathy Anyway? Patrick D. Walker, M.D. Nephropath Little Rock, Arkansas USA
C3G An Update What is C3 Glomerulopathy Anyway? Patrick D. Walker, M.D. Nephropath Little Rock, Arkansas USA C3 Glomerulopathy Overview Discuss C3 Glomerulopathy (C3G) How did we get to the current classification
More informationC1q nephropathy the Diverse Disease
C1q nephropathy the Diverse Disease Danica Galešić Ljubanović School of Medicine, University of Zagreb Dubrava University Hospital Zagreb, Croatia Definition Dominant or codominant ( 2+), mesangial staining
More informationA clinical syndrome, composed mainly of:
Nephritic syndrome We will discuss: 1)Nephritic syndrome: -Acute postinfectious (poststreptococcal) GN -IgA nephropathy -Hereditary nephritis 2)Rapidly progressive GN (RPGN) A clinical syndrome, composed
More informationGlomerular diseases mostly presenting with Nephritic syndrome
Glomerular diseases mostly presenting with Nephritic syndrome 1 The Nephritic Syndrome Pathogenesis: proliferation of the cells in glomeruli & leukocytic infiltrate Injured capillary walls escape of RBCs
More informationC3 Glomerulopathy. Rezan Topaloglu, MD Hacettepe University School of Medicine Department of Pediatric Nephrology Ankara, TURKEY
C3 Glomerulopathy Rezan Topaloglu, MD Hacettepe University School of Medicine Department of Pediatric Nephrology Ankara, TURKEY Journey in history Some diseases have journey Diagnoses may change during
More informationGlomerular pathology-2 Nephritic syndrome. Dr. Nisreen Abu Shahin
Glomerular pathology-2 Nephritic syndrome Dr. Nisreen Abu Shahin 1 The Nephritic Syndrome Pathogenesis: inflammation proliferation of the cells in glomeruli & leukocytic infiltrate Injured capillary walls
More informationFamilial DDD associated with a gain-of-function mutation in complement C3.
Familial DDD associated with a gain-of-function mutation in complement C3. Santiago Rodríguez de Córdoba, Centro de investigaciones Biológicas, Madrid Valdés Cañedo F. and Vázquez- Martul E., Complejo
More informationComplement in vasculitis and glomerulonephritis. Andy Rees Clinical Institute of Pathology Medical University of Vienna
Complement in vasculitis and glomerulonephritis Andy Rees Clinical Institute of Pathology Medical University of Vienna 41 st Heidelberg Nephrology Seminar March 2017 The complement system An evolutionary
More informationDr. Ghadeer Mokhtar Consultant pathologists and nephropathologist, KAU
Dr. Ghadeer Mokhtar Consultant pathologists and nephropathologist, KAU CLINICAL HISTORY A 4 year old Saudi girl presented to the ER with generalized body swelling, decrease urine output with passing dark
More informationFIBRILLARY GLOMERULONEPHRITIS DIAGNOSTIC CRITERIA, PITFALLS, AND DIFFERENTIAL DIAGNOSIS
FIBRILLARY GLOMERULONEPHRITIS DIAGNOSTIC CRITERIA, PITFALLS, AND DIFFERENTIAL DIAGNOSIS Guillermo A. Herrera MD Louisiana State University, Shreveport Fibrils in bundles 10-20 nm d Diabetic fibrillosis
More informationRenal Pathology 1: Glomerulus. With many thanks to Elizabeth Angus PhD for EM photographs
Renal Pathology 1: Glomerulus With many thanks to Elizabeth Angus PhD for EM photographs Anatomy of the Kidney http://www.yalemedicalgroup.org/stw/page.asp?pageid=stw028980 The Nephron http://www.beltina.org/health-dictionary/nephron-function-kidney-definition.html
More informationMonoclonal Gammopathies and the Kidney. Tibor Nádasdy, MD The Ohio State University, Columbus, OH
Monoclonal Gammopathies and the Kidney Tibor Nádasdy, MD The Ohio State University, Columbus, OH Monoclonal gammopathy of renal significance (MGRS) Biopsies at OSU (n=475) between 2007 and 2016 AL or AH
More informationLong-term follow-up of juvenile acute nonproliferative glomerulitis (JANG)
Pediatr Nephrol (2007) 22:1957 1961 DOI 10.1007/s00467-007-0555-6 BRIEF REPORT Long-term follow-up of juvenile acute nonproliferative glomerulitis (JANG) Teruo Fujita & Kandai Nozu & Kazumoto Iijima &
More informationFrom MPGN to C3G. F Fakhouri, Nantes, France. «Membranoproliferative» is a pathological feature. Mesangial expansion «Doubles contours»
From MPGN to C3G F Fakhouri, Nantes, France Conflits d intérêt: consultant auprès d Alexion Pharmaceuticals «Membranoproliferative» is a pathological feature Mesangial expansion «Doubles contours» Immune
More informationMICROSCOPIC HEMATURIA AND DIFFUSE NECROTIZING GLOMERULONEPHRITIS
MICROSCOPIC HEMATURIA AND DIFFUSE NECROTIZING GLOMERULONEPHRITIS Hatim Q. AlMaghrabi, MD, FRCPC Consultant at King Abdulaziz Medical City (NGHA) Jeddah Case Presentation 70 years old female Known hypertensive
More informationCase 3. ACCME/Disclosure. Laboratory results. Clinical history 4/13/2016
Case 3 Lynn D. Cornell, M.D. Mayo Clinic, Rochester, MN Cornell.Lynn@mayo.edu USCAP Renal Case Conference March 13, 2016 ACCME/Disclosure Dr. Cornell has nothing to disclose Clinical history 57-year-old
More informationSecondary IgA Nephropathy & HSP
Secondary IgA Nephropathy & HSP Anjali Gupta, MD 1/11/11 AKI sec to Hematuria? 65 cases of ARF after an episode of macroscopic hematuria have been reported in the literature in patients with GN. The main
More informationClassification of Glomerular Diseases and Defining Individual Glomerular Lesions: Developing International Consensus
Classification of Glomerular Diseases and Defining Individual Glomerular Lesions: Developing International Consensus Mark Haas MD, PhD Department of Pathology & Laboratory Medicine Cedars-Sinai Medical
More informationDr Ian Roberts Oxford. Oxford Pathology Course 2010 for FRCPath Illustration-Cellular Pathology. Oxford Radcliffe NHS Trust
Dr Ian Roberts Oxford Oxford Pathology Course 2010 for FRCPath Plan of attack: Diagnostic approach to the renal biopsy Differential diagnosis of the clinical syndromes of renal disease Microscopy Step
More informationDense deposit disease with steroid pulse therapy
Case Report Dense deposit disease with steroid pulse therapy Jun Odaka, Takahiro Kanai, Takane Ito, Takashi Saito, Jun Aoyagi, and Mariko Y Momoi Abstract Treatment of dense deposit disease DDD has not
More informationRENAL EVENING SPECIALTY CONFERENCE
RENAL EVENING SPECIALTY CONFERENCE Harsharan K. Singh, MD The University of North Carolina at Chapel Hill Disclosure of Relevant Financial Relationships No conflicts of interest to disclose. CLINICAL HISTORY
More informationDr Ian Roberts Oxford. Oxford Pathology Course 2010 for FRCPath Illustration-Cellular Pathology. Oxford Radcliffe NHS Trust
Dr Ian Roberts Oxford Oxford Pathology Course 2010 for FRCPath Present the basic diagnostic features of the commonest conditions causing proteinuria & haematuria Highlight diagnostic pitfalls Nephrotic
More informationRENAL HISTOPATHOLOGY
RENAL HISTOPATHOLOGY Peter McCue, M.D. Department of Pathology, Anatomy & Cell Biology Sidney Kimmel Medical College There are no conflicts of interest. 1 Goals and Objectives! Goals Provide introduction
More informationCASE 4 A RARE CASE OF INTRALUMINAL GLOMERULAR CAPILLARY DEPOSITS
CASE 4 A RARE CASE OF INTRALUMINAL GLOMERULAR CAPILLARY DEPOSITS DR ANNIE JOJO, Dr Seethalekshmy N V, Dr Nanda Kachare DEPARTMENT OF PATHOLOGY, AMRITA INSTITUTE OF MEDICAL SCIENCES, KOCHI. 54 yrs female,
More informationGlomerular diseases with organized deposits
Glomerular diseases with organized deposits Banu Sis, MD, FRCPC University of Alberta, Edmonton, AB, Canada Ulusal Patoloji Kongresi, Manavgat, Antalya 8/11/2012 What is an organized deposit? A number
More informationOverview of glomerular diseases
Overview of glomerular diseases *Endothelial cells are fenestrated each fenestra: 70-100nm in diameter Contractile, capable of proliferation, makes ECM & releases mediators *Glomerular basement membrane
More informationOrdering Physician. Collected REVISED REPORT. Performed. IgG IF, Renal MCR. Lambda IF, Renal MCR. C1q IF, Renal. MCR Albumin IF, Renal MCR
RenalPath Level IV Wet Ts IgA I Renal IgM I Renal Kappa I Renal Renal Bx Electron Microscopy IgG I Renal Lambda I Renal C1q I Renal C3 I Renal Albumin I Renal ibrinogen I Renal Mayo Clinic Dept. of Lab
More informationSurgical Pathology Report
Louisiana State University Health Sciences Center Department of Pathology Shreveport, Louisiana Accession #: Collected: Received: Reported: 6/1/2012 09:18 6/2/2012 09:02 6/2/2012 Patient Name: Med. Rec.
More informationApproach to Glomerular Diseases: Clinical Presentation Nephrotic Syndrome Nephritis
GLOMERULONEPHRITIDES Vivette D Agati Jai Radhakrishnan Approach to Glomerular Diseases: Clinical Presentation Nephrotic Syndrome Nephritis Heavy Proteinuria Renal failure Low serum Albumin Hypertension
More informationGlomerular Diseases. Anna Vinnikova, MD Nephrology
Glomerular Diseases Anna Vinnikova, MD Nephrology Classification of Glomerular Diseases http://what-when-how.com/acp-medicine/glomerular-diseases-part-1/ Classification of pathologic and clinical manifestations
More informationPost-infectious glomerulonephritis with crescents in adults: a retrospective study
ORIGINAL ARTICLE Clinical Kidney Journal, 2016, vol. 9, no. 2, 222 226 doi: 10.1093/ckj/sfv147 Advance Access Publication Date: 20 January 2016 Original Article Post-infectious glomerulonephritis with
More informationNephritic vs. Nephrotic Syndrome
Page 1 of 18 Nephritic vs. Nephrotic Syndrome Terminology: Glomerulus: A network of blood capillaries contained within the cuplike end (Bowman s capsule) of a nephron. Glomerular filtration rate: The rate
More informationC3 Glomerulopathy. Jun-Ki Park
C3 Glomerulopathy Jun-Ki Park 03.08.11 For the last 30 years classification MPGN is based on glomerular findings by light microscopy with further specification on EM and staining for Ig and complement
More informationsubstance staining with IgG, C3 and IgA (trace) Linear deposition of IgG(+), IgA.M(trace) and C3(+++) at the DEJ
Direct Immunofluorescence: Skin Diagnosis Findings Picture Pemphigus Vulgaris and it s Intracellular cement variants substance staining with IgG, C3 and IgA (trace) Bullous Pemphigoid and it s variants
More informationGOODPASTURE'S SYNDROME WITH CONCOMITANT IMMUNE COMPLEX MIXED MEMBRANOUS AND PROLIFERATIVE GLOMERULONEFRITIS
GOODPASTURE'S SYNDROME WITH CONCOMITANT IMMUNE COMPLEX MIXED MEMBRANOUS AND PROLIFERATIVE GLOMERULONEFRITIS VESNA JURČIĆ 1, ANDREJA ALEŠ RIGLER 2, INSTITUTE OF PATHOLOGY, FACULTY OF MEDICINE, UNIVERSITY
More informationACUTE GLOMERULONEPHRITIS. IAP UG Teaching slides
ACUTE GLOMERULONEPHRITIS 1 Definition Etiology Pathology/pathogenesis Risk factors Clinical Presentation Investigation Differential Diagnosis Management Outcome/Prognosis Indication for Renal Biopsy Summary
More informationDual positive serology in a case of rapidly progressive glomerulonephritis in a middle aged woman
CASE REPORT Advance Access publication 20 May 2014 Dual positive serology in a case of rapidly progressive glomerulonephritis in a middle aged woman Rubina Naqvi 1, Muhammed Mubarak 2 1 Department of Nephrology
More informationCASE OF THE WEEK 1
www.nephro-pathology.com CASE OF THE WEEK 1 Clinical Presentation: A 17 year old Indian boy presented with anasarca, decreased urine output and episodes of nausea and vomiting over the last three weeks.
More informationClassification of Glomerular Diseases and Defining Individual Glomerular Lesions: Developing International Consensus
Classification of Glomerular Diseases and Defining Individual Glomerular Lesions: Developing International Consensus Mark Haas MD, PhD Department of Pathology & Laboratory Medicine Cedars-Sinai Medical
More informationJournal of Nephropathology
www.nephropathol.com DOI: 10.12860/jnp.2014.22 J Nephropathol. 2014; 3(3): 115-120 Journal of Nephropathology Clinicopathological correlations in lupus nephritis; a single center experience Hamid Nasri
More informationLab 3, case 1. Is this an example of nephrotic or nephritic syndrome? Why? Which portion of the nephron would you expect to be abnormal?
Lab 3, case 1 12-year-old Costa Rican boy is brought into clinic by his parents because of dark brownish-red urine over the last 24 hours. The family has been visiting friends in Indianapolis for two weeks.
More informationEvidence Review: Title. Month/ Year. Evidence Review: Eculizumab in the treatment of recurrence of C3 glomerulopathy post-transplant
Evidence Review: Title Month/ Year Evidence Review: Eculizumab in the treatment of recurrence of C glomerulopathy post-transplant October 2015 1 Standard Operating Procedure: NHS England Evidence Review:
More informationAtypical IgA Nephropathy
Atypical IgA Nephropathy Richard J. Glassock, MD, MACP Geffen School of Medicine at UCLA XXXIII Chilean Congress of Nephrology, Hypertension and Transplantation Puerto Varas, Chile October 6, 2016 IgA
More informationGlomerular pathology in systemic disease
Glomerular pathology in systemic disease Lecture outline Lupus nephritis Diabetic nephropathy Glomerulonephritis Associated with Bacterial Endocarditis and Other Systemic Infections Henoch-Schonlein Purpura
More informationCase # 2 3/27/2017. Disclosure of Relevant Financial Relationships. Clinical history. Clinical history. Laboratory findings
Case # 2 Christopher Larsen, MD Arkana Laboratories Disclosure of Relevant Financial Relationships USCAP requires that all planners (Education Committee) in a position to influence or control the content
More information55 th ERA-EDTA Congress May 26, 2018 Preliminary Proof-of-Concept Data
Factor D Inhibition with ACH-4471 Reduces Complement Alternative Pathway Hyperactivity and Proteinuria in C3 Glomerulopathy: Preliminary Proof-of-Concept Data Hetal Kocinsky 1, Cass Kelleher 1, Angela
More informationJournal of Nephropathology
www.nephropathol.com DOI: 10.15171/jnp.2017.36 J Nephropathol. 2017;6(3):220-224 Journal of Nephropathology Proliferative glomerulonephritis with monoclonal IgG deposits; an unusual cause of de novo disease
More informationRejection or Not? Interhospital Renal Meeting 10 Oct Desmond Yap & Sydney Tang Queen Mary Hospital
Rejection or Not? Interhospital Renal Meeting 10 Oct 2007 Desmond Yap & Sydney Tang Queen Mary Hospital Case Presentation F/61 End stage renal failure due to unknown cause Received HD in private hospital
More informationClinico-pathologic spectrum of C3 glomerulopathy-an Indian experience
Viswanathan et al. Diagnostic Pathology (2015) 10:6 DOI 10.1186/s13000-015-0233-0 RESEARCH Open Access Clinico-pathologic spectrum of C3 glomerulopathy-an Indian experience Ganesh Kumar Viswanathan 1,
More informationTHE URINARY SYSTEM. The cases we will cover are:
THE URINARY SYSTEM The focus of this week s lab will be pathology of the urinary system. Diseases of the kidney can be broken down into diseases that affect the glomeruli, tubules, interstitium, and blood
More informationHistopathology: Glomerulonephritis and other renal pathology
Histopathology: Glomerulonephritis and other renal pathology These presentations are to help you identify basic histopathological features. They do not contain the additional factual information that you
More informationA Case of IgG2 Heavy Chain Deposition Disease in a Patient with Kappa Positive Plasma Cell Dyscrasia
Published online: August 14, 2014 2296 9705/14/0051 0006$39.50/0 This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC)
More informationDiagnostic dilemmas in a girl with acute glomerulonephritis: Answers
Pediatr Nephrol (2018) 33:65 69 DOI 10.1007/s00467-017-3626-3 CLINICAL QUIZ Diagnostic dilemmas in a girl with acute glomerulonephritis: Answers Farah A. Falix 1 & Michiel J. S. Oosterveld 1 & Sandrine
More informationClinical pathological correlations in AKI
Clinical pathological correlations in AKI Dr. Rajasekara chakravarthi Director - Nephrology Star Kidney Center, Star Hospitals Renown clinical services India Introduction AKI is common entity Community
More informationTHE URINARY SYSTEM. The cases we will cover are:
THE URINARY SYSTEM The focus of this week s lab will be pathology of the urinary system. Diseases of the kidney can be broken down into diseases that affect the glomeruli, tubules, interstitium, and blood
More informationClinical Study Glomerulonephritis with Crescents in Children: Etiology and Predictors of Renal Outcome
International Scholarly Research Network ISRN Pediatrics Volume 2011, Article ID 507298, 5 pages doi:10.5402/2011/507298 Clinical Study Glomerulonephritis with Crescents in Children: Etiology and Predictors
More informationC3 Glomerulonephritis versus C3 Glomerulopathies?
Washington University School of Medicine Digital Commons@Becker Kidneycentric Kidneycentric 2016 C3 Glomerulonephritis versus C3 Glomerulopathies? T. Keefe Davis Washington University School of Medicine
More informationInteresting case seminar: Native kidneys Case Report:
Interesting case seminar: Native kidneys Case Report: Proximal tubulopathy and light chain deposition disease presented as severe pulmonary hypertension with right-sided cardiac dysfunction and nephrotic
More informationPost-infectious (bacterial) Glomerulonephritis
Far East Regional Conference Russia Dialysis Society Khabarovsk, Russia October 30, 2015 Post-infectious (bacterial) Glomerulonephritis (An Update) William Couser, MD Affiliate Professor of Medicine University
More informationESRD Dialysis Prevalence - One Year Statistics
Age Group IL Other Total 00-04 12 1 13 05-09 5 2 7 10-14 15 1 16 15-19 55 2 57 20-24 170 10 180 25-29 269 14 283 30-34 381 9 390 35-39 583 14 597 40-44 871 20 891 45-49 1,119 20 1,139 50-54 1,505 35 1,540
More informationPATTERNS OF RENAL INJURY
PATTERNS OF RENAL INJURY Normal glomerulus podocyte Glomerular capillaries electron micrograph THE CLINICAL SYNDROMES 1. The Nephrotic Syndrome 2. The Acute Nephritic Syndrome 3. Rapidly Progressive Glomerulonephritis
More informationMembranoproliferative Glomerulonephritis
Membranoproliferative Glomerulonephritis MPGN is characterizedby alterations in the GBM and mesangium and by proliferation of glomerular cells. 5% to 10% of cases of 1ry nephrotic syndrome in children
More informationCHAPTER 2. Primary Glomerulonephritis
2nd Report of the PRIMARY GLOMERULONEPHRITIS CHAPTER 2 Primary Glomerulonephritis Sunita Bavanandan Lee Han Wei Lim Soo Kun 21 PRIMARY GLOMERULONEPHRITIS 2nd Report of the 2.1 Introduction This chapter
More informationElevated Serum Creatinine, a simplified approach
Elevated Serum Creatinine, a simplified approach Primary Care Update Creighton University School of Medicine. April 27 th, 2018 Disclosure Slide I have no disclosures and have no conflicts with this presentation.
More informationNephrotic syndrome minimal change disease vs. IgA nephropathy. Hadar Meringer Internal medicine B Sheba
Nephrotic syndrome minimal change disease vs. IgA nephropathy Hadar Meringer Internal medicine B Sheba The Case 29 year old man diagnosed with nephrotic syndrome 2 weeks ago and complaining now about Lt.flank
More information29th Annual Meeting of the Glomerular Disease Collaborative Network
29th Annual Meeting of the Glomerular Disease Collaborative Network Updates on the Pathogenesis IgA Nephropathy and IgA Vasculitis (HSP) J. Charles Jennette, M.D. Brinkhous Distinguished Professor and
More informationJ Nephropharmacol. 2014; 3(2): Journal of Nephropharmacology
J Nephropharmacol. 2014; 3(2): 33 37. NPJ Journal of Nephropharmacology Pathological patterns of mesangioproliferative glomerulonephritis seen at a tertiary care center Ghadeer A. Mokhtar 1*, Sawsan Jalalah
More informationCHAPTER 2 PRIMARY GLOMERULONEPHRITIS
CHAPTER 2 Sunita Bavanandan Lim Soo Kun 19 5th Report of the 2.1: Introduction This chapter covers the main primary glomerulonephritis that were reported to the MRRB from the years 2005-2012. Minimal change
More informationClinical spectrum and outcome of crescentic glomerulonephritis in children in developing countries
Pediatr Nephrol (2008) 23:389 394 DOI 10.1007/s00467-007-0647-3 ORIGINAL ARTICLE Clinical spectrum and outcome of crescentic glomerulonephritis in children in developing countries Deepak Dewan & Sanjeev
More informationC3 glomerulopathy: consensus report
http://www.kidney-international.org & 2013 International Society of Nephrology OPEN C3 glomerulopathy: consensus report Matthew C. Pickering 1, Vivette D. D Agati 2, Carla M. Nester 3,4, Richard J. Smith
More informationACCME/Disclosure. Case #1. Case History. Dr. Bracamonte has nothing to disclose
Case #1 ACCME/Disclosure Dr. Erika Bracamonte Associate Professor of Pathology University of Arizona, College of Medicine Banner University Medical Center, Tucson Dr. Bracamonte has nothing to disclose
More informationRapidly progressive glomerulonephritis. Alan Salama UCL Centre for Nephrology Royal Free Hospital
Rapidly progressive glomerulonephritis Alan Salama UCL Centre for Nephrology Royal Free Hospital Remember this. AKI Acute tubular injury Not all AKI is caused by sepsis or volume depletion AKI is caused
More informationImmune complex deposits in ANCA-associated crescentic glomerulonephritis: A study of 126 cases
Kidney International, Vol. 65 (2004), pp. 2145 2152 Immune complex deposits in ANCA-associated crescentic glomerulonephritis: A study of 126 cases MARK HAAS and JOSEPH A. EUSTACE Department of Pathology
More informationRECURRENT AND DE NOVO RENAL DISEASES IN THE ALLOGRAFT. J. H. Helderman,MD,FACP,FAST
RECURRENT AND DE NOVO RENAL DISEASES IN THE ALLOGRAFT J. H. Helderman,MD,FACP,FAST Vanderbilt University Medical Center Professor of Medicine, Pathology and Immunology Medical Director, Vanderbilt Transplant
More informationImmune profile of IgA-dominant diffuse proliferative glomerulonephritis
Clin Kidney J (2014) 7: 479 483 doi: 10.1093/ckj/sfu090 Exceptional Case Immune profile of IgA-dominant diffuse proliferative glomerulonephritis Eric Wallace 1, Nicolas Maillard 2, Hiroyuki Ueda 2, Stacy
More informationClinical and pathological characteristics of patients with glomerular diseases at a university teaching hospital: 5-year prospective review
Clinical and pathological characteristics of patients with glomerular diseases at a university teaching hospital: 5-year prospective review KW Chan, TM Chan, IKP Cheng Objective. To examine the prevalence
More informationMultiple Myeloma Advances for clinical pathologists & histopathologists
Multiple Myeloma Advances for clinical pathologists & histopathologists CME in Haematology 2014 IAPP & Dept of Pathology, BVDUMC, Pune Sunday, 4 th May 2014 Dr. M.B. Agarwal, MD, MNAMS Head, Dept of Haematology
More informationGlomerular Diseases. Davis Massey, MD, PhD Surgical Pathology Anna Vinnikova, MD Nephrology
Glomerular Diseases Davis Massey, MD, PhD Surgical Pathology Anna Vinnikova, MD Nephrology Classification of Glomerular Diseases http://what-when-how.com/acp-medicine/glomerular-diseases-part-1/ Classification
More informationTuesday Conference 7/23/2013. Hasan Fattah
Tuesday Conference 7/23/2013 Hasan Fattah 48 AA male, PMH: HTN, proteinuria since 2009, sent from primary clinic for high Cr evaluation (7.1), last known of 1.1 in 2010 associated with sub-nephrotic range
More informationThe CARI Guidelines Caring for Australasians with Renal Impairment. Specific management of IgA nephropathy: role of steroid therapy GUIDELINES
Specific management of IgA nephropathy: role of steroid therapy Date written: July 2005 Final submission: September 2005 Author: Merlin Thomas GUIDELINES Steroid therapy may protect against progressive
More informationAcute Glomerulonephritis in Southern Iran
Original Article Iran J Pediatr Jun 2008; Vol 18 ( No 2), Pp:143-148 Acute Glomerulonephritis in Southern Iran Ali Derakhshan* 1, MD, Pediatric Nephrologist; Vahid Reza Hekmat 2, Medical Student 1. Shiraz
More informationOriginal. IgAN. Key words : IgA nephropathy, IgM deposition, proteinuria, tonsillectomy, steroid pulse therapy. Introduction
Showa Univ J Med Sci 27 3, 167 174, September 2015 Original Prominent IgM Deposition in Glomerulus Is Associated with Severe Proteinuria and Reduced after Combined Treatment of Tonsillectomy with Steroid
More informationRenal manifestations of IgG4-related systemic disease
Renal manifestations of IgG4-related systemic disease Lynn D. Cornell, M.D. Mayo Clinic Rochester, MN While autoimmune pancreatitis (AIP) has been recognized since the first description by Sarles et al
More informationC3 Glomerulopathy: Clinicopathologic Features and Predictors of Outcome
CJASN epress. Published on October 31, 2013 as doi: 10.2215/CJN.04700513 Article C3 Glomerulopathy: Clinicopathologic Features and Predictors of Outcome Nicholas R. Medjeral-Thomas,* Michelle M. O Shaughnessy,
More informationIndex. electron microscopy, 81 immunofluorescence microscopy, 80 light microscopy, 80 Amyloidosis clinical setting, 185 etiology/pathogenesis,
A Acute antibody-mediated rejection (Acute AMR) clinical features, 203 clinicopathologic correlations, 206 pathogenesis, 205 206 204 205 light microscopy, 203 204 Acute cellular rejection (ACR) clinical
More informationJo Abraham MD Division of Nephrology University of Utah
Jo Abraham MD Division of Nephrology University of Utah 68 year old male presented 3 weeks ago with a 3 month history of increasing fatigue He reported a 1 week history of increasing dyspnea with a productive
More informationClinicopathologic Characteristics of IgA Nephropathy with Steroid-responsive Nephrotic Syndrome
J Korean Med Sci 2009; 24 (Suppl 1): S44-9 ISSN 1011-8934 DOI: 10.3346/jkms.2009.24.S1.S44 Copyright The Korean Academy of Medical Sciences Clinicopathologic Characteristics of IgA Nephropathy with Steroid-responsive
More informationExpanding Spectrum of Diseases Associated with Plasma Cell Dyscrasias
Expanding Spectrum of Diseases Associated with Plasma Cell Dyscrasias Eva Honsova Institute for Clinical and Experimental Medicine Prague, Czech Republic eva.honsova@ikem.cz Plasma cell dyscrasias Plasma
More informationClinical Findings, Pathology, and Outcomes of C3GN after Kidney Transplantation
CLINICAL RESEARCH www.jasn.org Clinical Findings, Pathology, and Outcomes of C3GN after Kidney ation Ladan Zand,* Elizabeth C. Lorenz,* Fernando G. Cosio,* Fernando C. Fervenza,* Samih H. Nasr, Manish
More informationSPECTRUM OF GLOMERULAR DISEASES: AN 11 YEAR RETROSPECTIVE REVIEW IN A TERTIARY CARE HOSPITAL IN PAKISTAN.
Original Article AN 11 YEAR RETROSPECTIVE REVIEW IN A TERTIARY CARE HOSPITAL IN PAKISTAN. * * * Naila Asif, Kunwer Naveed Mukhtar, Farzana Adnan * Assistant Professor, Consultant Nephrologist, Department
More informationGlomerular Pathology- 1 Nephrotic Syndrome. Dr. Nisreen Abu Shahin
Glomerular Pathology- 1 Nephrotic Syndrome Dr. Nisreen Abu Shahin The Nephrotic Syndrome a clinical complex resulting from glomerular disease & includes the following: (1) massive proteinuria (3.5 gm /day
More informationRenal Data from the Arab World
Saudi J Kidney Dis Transpl 2013;24(2):387-391 2013 Saudi Center for Organ Transplantation Saudi Journal of Kidney Diseases and Transplantation Renal Data from the Arab World Pattern of Glomerular Diseases
More informationToward a working definition of C3 glomerulopathy by immunofluorescence
http://www.kidney-international.org & 2013 International Society of Nephrology Toward a working definition of C3 glomerulopathy by immunofluorescence Jean Hou 1, Glen S. Markowitz 1, Andrew S. Bomback
More informationHasan Fattah 4/30/2013
Hasan Fattah 4/30/2013 49 yo hispanic male, ho HIV(CD4 229), currently on HAART, course c/b AIDS, Presents with two days ho fever, SOB, blood tinged sputum, and visible hematuria. ROS: no skin rash, joint
More informationAn unusual association between focal segmental sclerosis and lupus nephritis: a distinct concept from lupus podocytopathy?
CEN Case Rep (2015) 4:70 75 DOI 10.1007/s13730-014-0142-1 CASE REPORT An unusual association between focal segmental sclerosis and lupus nephritis: a distinct concept from lupus podocytopathy? Hironari
More informationGlomerulonephritis Associated with Bacterial Infection
Glomerulonephritis Associated with Bacterial Infection The Emerging Role of Staphylococcus Tibor Nádasdy, MD Clinical history (Case #1) 60-year-old Caucasian male with insulin dependent DM, diabetic
More information