Diabetic Nephropathy (case 2)


Figure A. PAS x40

Figure B. PAS x40

Figure C. PAS x40

Figure D. Trichrome x20

Figure E. Jones x40

 

   

 

Clinical History: 67 year old female with long standing and uncontrolled diabetes mellitus, now with nephrotic range proteinuria (5.5 g/ 24 hr) and actively rising creatinine (6.6 mg/ dL). 

Histology: The glomeruli show severe, diffuse glomerulosclerosis with mesangial expansion and many nodular lesions. Some glomeruli show capillary aneurysms and others show focal segmental glomerulosclerosis changes with foam cells. The interstitial space shows moderate expansion with extensive tubular atrophy and moderate fibrosis and chronic inflammation. PAS staining confirms the presence of PAS positive deposits in the mesangial spaces, some with nodular appearance and thickening of the basement membrane of capillary loops and tubules. The trichrome stain in Figure D shows nodular sclerosis and interstitial fibrosis. The glomerular basement membrane thickening and nodular mesangial expansion is shown by Jones silver stain in figure E.

 


(Last Edition: February 21, 2024 )