Case
179 With discussion |
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Versión
en Español |
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CASE 179 (January 2021)
Clinical information
A 60-year-old woman was noted to have urinary protein and hypertension on a health examination. She was referred to ambulatory care center for further evaluation and treatment. On admission, the patient had a blood pressure of 147/96 mmHg. Skin, cardiac, pulmonary, and abdominal examination findings were unremarkable. Laboratory tests: proteinuria: 1.3 g/24h, without hematuria or leukocyturia, with phosphaturia and glucosuria; normal values of serum total protein: 7.6 g/dL, albumin: 4.2 g/dL, creatinine: 0.8 mg/dL, uric acid: 3.3 mg/dL. C3: 93 mg/dL (90-180), C4: 16 mg/dL (10–40). ANA, anti-DNA and ANCA: negative. Viruses tests: negative.
Kidney biopsy was done. Look at the images.
Figure 1. H&E, X100. Almost normal appearance.
Figure 2. H&E, X400. Normal glomeruli.
Figure 3. Masson's trichrome stain, X400.
Figure 4. H&E, methenamine-silver stain, X400.
Figure 5. Masson's trichrome stain, X400.
Figure 6. H&E, X400.
Figure 7. H&E, X200.
Figure 8. H&E, X400.
Figure 9. H&E, X600. Intracytoplasmic crystals.
Figure 10. H&E, X1,000.
Figure 11. Direct immunofluorescence for kappa light chain, X400.
Figure 12. Direct immunofluorescence for lambda light chain, X400.
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