|
Clinical History:
65-year-old female with a acute renal
insufficiency in the setting of rheumatoid arthritis
with negative serology. Anemia (8g/ dL), serum
creatinine = 3.43 mg/ dL, serum albumin = 1.9 g/ dL and
decreased C3 (20 mg/ dL)
Histology: Glomeruli
show moderate endocapillary proliferation with mild
mesangial hypercellularity and mild mesangial expansion.
The tubular structures show moderate to severe
epithelial simplification with loss of brush borders
and many tubules filled with cellular debris and
proteinaceous
material. Immunoflourescence staining in Figure E is
positive for C3.
Electron micrograph in Figure F, G, H show multiple
intramembranous immune-complex deposits, as well as
occasional subepithelial and mesangial deposits. The
endothelial cells show mild to moderate swelling and the
epithelial cells show extensive
effacement of foot processes. |
