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Unusual Biopsy Findings in a Hepatitis C–Infected White Man With Cryoglobulinemia, Purpuric Rash, and Renal Failure  Sumit Mohan, MBBS, MPH, Manasvi Jaitly,

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Presentation on theme: "Unusual Biopsy Findings in a Hepatitis C–Infected White Man With Cryoglobulinemia, Purpuric Rash, and Renal Failure  Sumit Mohan, MBBS, MPH, Manasvi Jaitly,"— Presentation transcript:

1 Unusual Biopsy Findings in a Hepatitis C–Infected White Man With Cryoglobulinemia, Purpuric Rash, and Renal Failure  Sumit Mohan, MBBS, MPH, Manasvi Jaitly, MBBS, MS, Jen-Tse Cheng, MD, Vivette D. D’Agati, MD, Velvie A. Pogue, MD  American Journal of Kidney Diseases  Volume 48, Issue 3, Pages (September 2006) DOI: /j.ajkd Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

2 Fig 1 A glomerulus is infiltrated by eosinophilic amorphous material that expands the mesangium. The interstitium is diffusely expanded by moderate edema and fibrosis accompanied by a moderate interstitial inflammatory infiltrate of mononuclear leukocytes. Proximal tubules show widespread degenerative and regenerative changes (hematoxylin and eosin; original magnification ×100). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

3 Fig 2 Mesangial material is weakly periodic acid–Schiff positive and paler than the matrix of the glomerular basement membrane (periodic acid–Schiff; original magnification ×250). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

4 Fig 3 Congo red stain for amyloid viewed under polarized light showed apple green birefringence in the distribution of the glomerular mesangium and afferent arteriole (Congo red stain; original magnification ×100). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

5 Fig 4 By electron microscopy, the glomerular basement membrane is infiltrated by randomly oriented nonbranching fibrils of 8 to 10 nm in diameter that extend from the subendothelial to the subepithelial aspect, forming spicular projections toward the urinary space. There is overlying effacement of foot processes (electron micrograph; original magnification ×6,000). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

6 Fig 5 Immunoperoxidase stain for SAA protein shows positivity in the distribution of the glomerulus and small arteries, consistent with AA amyloidosis (immunoperoxidase; original magnification ×100). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions


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