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Dear nephrologist: Not all #renalpath diagnoses are created equal. Some are much less than others, and acute tubular injury/ ATN is among the least. Here are the reasons: 1. If we look hard enough, tubular injury is almost always present in the kidney bx. 1/

Guillain-Barré syndrome and NELL1 membranous nephropathy due to mercury toxicity kidney-international.org/article/S0085-…

When one paraprotein associated lesion is not enough. Concurrence of focal light chain cast nephropathy, monoclonal immunoglobulin deposition disease, and microangiopathy in a patient with plasma cell dyscrasia (igg-kappa). #renalpath #pathtwitter #nephrology

Case of insiduous advanced presentation of IgAN/TMA as the first diagnosis. Young pt with AKI and hypertensive urgency. Bx with extensive chronic changes (>70% GS, IFTA), rare fibrocellular crescent, 4+ IgA by IF, and focal TMA. #renalpath #nephrology #PathTwitter

I enjoyed this perspective piece on value of membranous antigen testing and its impact (or not) in a variety of clinical scenarios. Many great points in this piece; but the bottom line is a careful clinical history is still the best test. #renalpath #nephrology #pathtwitter

1. Is this MGRS? This is common when we see CKD patients with monoclonal gammopathy? Our work in KI can aid clinician in this situation! Let's dive in this paper! kidney-international.org/article/S0085-… Ladan Zand fernando fervenza Sanjeev Sethi Mayo Clinic Nephrology UMN Division of Nephrology & Hypertension American Society of Onconephrology

IgM Variant of Proliferative Glomerulonephritis With Monoclonal Immunoglobulin Deposits: A Case Series bit.ly/3Ec18Od #OpenAccess Bhanu Prasad Sanjeev Sethi #VisualAbstract

One of my favorite incidental/normal EM findings: crystalline pro-renin granules in JGA cells. No to be confused with any sort of paraprotein related processes. #renalpath #nephrology #pathtwitter

糖尿病性糸球体硬化症だけかなと思って、間質をよくみるとアミロイドーシスも。一つ見つけて安心すると他のを見逃しやすくなる。

KIReports Jai Radhakrishnan Sumit Mohan Sophia Ambruso Stephen Pastan Gerren Hobby Rajiv Agarwal MD, MS Denisse Arellano Suman Behera Mark Perazella Peter Kotanko Jochen Raimann ➡️ Spectrum of Kidney Pathology in Patients with Syphilis kireports.org/article/S2468-…

Nice examples of subepithelial hump-like deposits in cases of recurrent C3GN/DDD. Found in 31% of recurrent C3G patient bx's in our institutional series (indication bx's). Exudative features also common (25% of cases). wjgnet.com/2220-3230/full… #renalpath #pathtwitter #nephrology

MPO-ANCA associated vasculitis with prominent necrotizing arteritis. Interestingly, the arteritis in this case was very active despite only rare ~10% fibrocellular to fibrous crescents in glomeruli. #renalpath #pathtwitter #nephrology

Txp biopsy with persistent heavy proteinuria since early post-transplant period in a recipient of a peds split en-bloc graft. Pediatric donor glomerulopathy with segmental sclerosis, mesangial hypercellularity, and atypical GBM remodeling. #renalpath #nephrology #PathTwitter

Methamphetamine abuse=severe thrombotic microangiopathy Unfortunate weekend case 😢 Glomeruli: mesangiolysis +++ & ischemic changes Interstitium: Hemorrhage, inflammation & scarring Vessels: Severe sclerosis, thrombosis, schistocytes 40-yr woman, hypertension, AKI, meth abuse

While the trichrome stain is best known for assessing the extent of interstitial fibrosis, it is a versatile stain with many applications. In this high-magnification image of a proliferative glomerulonephritis, the arrow points to red-pink (i.e. “fuchsinophilic”) subepithelial

HEV-associated endocapillary proliferative glomerulonephritis in an immunocompetent adult - Kidney International Reports kireports.org/article/S2468-…

ALECT2 amyloidosis in a patient with myeloma cast nephropathy - Kidney International kidney-international.org/article/S0085-…

Cryoglobulinemic GN related to Q fever endocarditis doi.org/10.1016/j.kint…