Erschienen in:
27.04.2021 | Lessons for the Clinical Nephrologist
Destructuring glomerular diseases with structured deposits: challenges in the precision medicine era
Erschienen in: Journal of Nephrology | Ausgabe 6/2021
Einloggen, um Zugang zu erhaltenExcerpt
A 56-year-old man with arterial hypertension, previous history of melanoma with negative follow-up and benign prostatic hyperplasia presented with scrotal edema, subnephrotic proteinuria (2.1 g/die) and microhematuria with an initial decrease in renal function (serum creatinine 1.4 mg/dl). Physical examination and ultrasound showed varicocele as a possible cause of the edema, but further laboratory tests revealed hypocomplementemia (C3 20 mg/dl and C4 3 mg/dl) with negative autoimmunity and viral markers. Renal biopsy showed a glomerulocentric deposition of hyaline, acellular, amorphous material occupying mesangial areas and capillary walls, with slight positivity to PAS stain (Fig. 1a) and negativity to Jones silver stain (Fig. 1b). No vascular nor tubulointerstitial involvement by these deposits was noted. Immunofluorescence on snap-frozen tissue was positive for IgG, with clear cut lambda light chain restriction (Fig. 1c, d).
Fig. 1
Renal biopsy showed diffuse and global glomerular deposition of amorphous, acellular, hyaline, weakly PAS-positive (a, × 20) and Jones-negative (b, × 20) material occupying the mesangial space and capillary walls. No vascular nor tubulointerstitial deposition was noted. Immunofluorescence on frozen tissue demonstrated bright (3 +) IgG positivity (c, × 20) with restriction for lambda immunoglobulin light chains (d, × 20)
× ![]()
…