Renal Pathology 3

Systemic Lupus Erythematosus

Henoch-Schonlein Purpura • Consists of – Purpuric skin lesions on the extensor surfaces of the arms, legs and buttocks – Abdominal manifestations – pain, vomiting and intestinal bleeding – Nonmigratory arthritis – Renal abnormalities

•LM: proliferative, crescents •IF: mesangial IgA +/- C3 and IgG •Vasculitis in dermis and GIT

Diabetic Glomerulosclerosis • A leading cause of ESRD • Proteinuria in 50% 12 to 22 years after clinical appearance of diabetes, decresing GFR and retinopathy • Morphology – Diffuse glomerulosclerosis • Diffuse increase in mesangial matrix • Mild mesangial cell proliferation • Overall thickening of GBM

–Nodular glomerulosclerosis •Kimmelsteil-Wilson disease •Pathognomic of DM •Ovoid or spherical, often laminated, hyaline masses situated in the periphery of the glomerulus •IF: Bright linear staining along the GBM and TBM •EM: GBM thickening and increase in mesangial matrix, often nodular

Amyloidosis • Heavy proteinuria or nephrotic syndrome • LM: normal, nodules, or diffuse thickening of GBM and mesangium • IF: non-contributory • EM: rigid non-branching fibrils (mesangium and GBM) • Course: bad prognosis