Diabetic Nephropathy (case 1)


Figure A. PAS x40

Figure B. PAS x40

Figure C. PAS x40

Figure D. EM

Figure E. EM

 

 

   

 

Clinical History: Morbidly obese 55 year old male with nephrotic range proteinuria and a long standing history of poorly controlled Diabetes Mellitus type 1. He also has mild to moderate hypertension

Histology: Figures A, B, C show moderate to severe glomerulosclerosis with mesangial expansion, capillary aneurysms and nodular lesion also called Kimmelstiel-Wilson nodule ( pointed by arrow in Figure C). The interstitial space shows moderate to severe expansion with focal atrophy of some tubules, fibrosis and chronic inflammation. PAS staining ( Figures A, B, C, D) confirms the presence of PAS positive nodular deposits in the mesangial spaces. There is also thickening of the Bowman's capsule, as well as thickening of the basement membrane of capillary loops, tubules and arterioles.

Electron micrographs (Figure D and E) show basement membranes thickening at the lamina densa and extensive mesangial matrix accumulation. There is also widespread foot process effacement

 


(Last Edition: February 21, 2024 )