CASE 71 (January 2012)
The patient is a 11-year-old boy. He presented nephrotic syndrome at 3-year-old, with complete response to steroids. Two recurrence episodes at 4 years of age. Asymptomatic since then. Now he is evaluated due to edemas. On laboratory tests was found hypoalbuminemia, dyslipidemia and proteinuria: 300 mg/m2/h. Blood cells count was normal. Tests for viruses: Negative. Serum complement: normal. ANA, ANCA: Negative.
With diagnosis of recurrent nephrotic syndrome, a renal biopsy was undertaken. See the images.
Figure 1. H&E, X100.
Figure 2. H&E, X400.
Figure 3. H&E, X400.
Figure 4. PAS stain, X400.
Figure 5. Masson's trichrome stain, X400.
Figure 6. Methenamine-silver stain, X400.
Figure 7. Methenamine-silver stain, X400.
Direct immunofluorescence for IgA, IgG, IgM, C3, C1q, kappa, and lambda: Negative.
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