CASE 2 (April 2006)
A 20-years-old man was referred because one month earlier he developed facial and legs oedema, general malaise and oliguria.
On examination, blood pressure was 160/100, heart rate 90 beats per minute, respiratory rate 16 breaths per minute. He was in no distress; he did not have fever. The general physical and neurologic examinations disclosed legs grade II oedema and no other abnormalities.
What is your clinical diagnosis?
What is the differential diagnosis?
A renal biopsy was undertaken. See the images.
Figure 1. (H&E, x400)
Figure 2. (H&E, x400)
Figure 3. (Methenamine silver stain, x400)
Figure 4. (Immunofluorescence using antiserum to IgG, X400)
Figure 5. (Immunofluorescence using antiserum to C3, X400)
Immunofluorescence for IgA, IgM, and C1q were negative.
What is your diagnosis?