CASE 125 (July 2016)
The patient is a 66-year-old woman with no medical history. For a month now presents with nephrotic syndrome and moderate hypertension. Normal blood count, creatinine 1.2 mg/dL, c-ANCA weak positive, proteinuria 7 g/24 h, urinary sediment: red cells 10-12/HPF. Autoimmune, infectious and neoplastic causes were ruled out.
See the images of the renal biopsy.
Figure 1. H&E, X100.
Figure 2. H&E, X200.
Figure 3. PAS, X400.
Figure 4. Masson's trichrome stain, X400.
Figure 5. PAS, X1,000.
Figure 6. Masson's trichrome stain, X1,000.
Figure 7. Masson's trichrome stain, X1,000.
Direct immunofluorescence for IgA, IgG, IgM, C3, C1q, kappa, and lambda: Negative.
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