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Clinical History: A 71
year old male with history of hypertension now
presenting with rising creatinine over last year with
hematuria and proteinuria.
Histology:
The
glomeruli show moderate to severe mesangial cell
hypercellularity with diffuse endocapillary
proliferation, focal mesangial matrix expansion and
split of the basement membranes. Crescentic lesion and
focal glomerular tuft adhesions to the Bowman's capsule
are also present. Trichrome stain (Figure C) shows focal
areas of tubular atrophy and interstitial fibrosis with
mild to moderate chronic inflammation. PAS staining
(Figures B, F, G) highlights the presence of focal PAS
positive deposits in the mesangial spaces.
Immunofluorescence (Figure D, H) show positivity for IgA
(+3) and C3 (+1). |
