Immunofluorescence Description -- Nephrotic Syndrome and Gross Hematuria

IMMUNOFLUORESCENCE EXAMINATION:

The tissue examined by immunofluorescence contained eight (8) non-sclerotic glomeruli, one (1) sclerotic glomerulus, one (1) artery and approximately five (5) arterioles. Direct immunofluorescence was performed using a panel of ten antisera. The results are presented in Table 1. In summary, the immunofluorescence studies showed the presence of diffuse, ribbony/linear to sparsely granular glomerular and focal tubular basement membrane staining for C3 (IMAGE 06) without a corresponding immunoglobulin component. In addition, mesangial and/or focal segmental staining for IgM and C3 was observed as were podocyte and tubular epithelial protein resorption droplets. Also identified was chronic vascular injury.

Table 1. RESULTS OF IMMUNOFLUORESCENCE STUDIES

	IgG	IgM	IgA	C1q	C3	C4	Fib	Alb	Kap	Lam
Glomeruli
Linear Diffuse								1+
Granular (MES)		1+								1+
Focal, Segmental		2+*			2+*					1+
PRD	2+				2+			3+	1-2+	3+
Ribbony BM					2+
Tubules
ECRD								1+
Ribbony BM					2+			1+
Casts	1+	1+	1+		1+					1+
Interstitium
Cells		1+						1+
Vessels
Arteries					1-2+
Arterioles					3+
Capillaries							2+

1+ to 4+ : Staining intensity from least to greatest

Abbreviations: Fib: Fibrinogen
Alb: Albumin
Kap: Kappa
Lam: Lambda
MES: Mesangium
PRD: Podocyte resorption droplet
ECRD: Epithelial cell resorption droplet
BM: Basement membrane
*: Single glomerulus

FINAL DIAGNOSIS