Pathology of Glomerular Diseases : Atlas of Clinical Case Studies

This book provides clear understanding of morphological appearances of various glomerular lesions encountered in a wide range of diseases involving renal glomeruli. Chapters cover various diseases with each chapter including a brief text and multiple colored microphotographs depicting the distinctive morphological features of glomeruli as may be encountered in these diseases. It presents complete clinical history with thorough lab workup and other related investigations as considered essential for proper evaluation of the patient. The book provides systemic approach for proper diagnosis of the underlying disease condition in view of the clinical workup and renal biopsy assessment. It provides visual understanding of the glomerular pathology that helps the consultant nephrologist to have a clear understanding of underlying renal disease thus helping in proper evaluation and appropriate therapeutic management of the patient. It may also guide to predict the likely prognostic outcome of the patient. This book is not only helpful to renal pathologists and nephrologists but also serves as a valuable resource for clear understanding of the glomerular lesions to the beginners and postgraduates in nephrology and renal pathology and other physicians managing the patients of renal diseases Foreword Preface Acknowledgments Contents 1: Evaluation of Renal Biopsy 1.1 Laboratory Procedure 1.2 Histopathological Evaluation 1.3 Glomerular Lesions 1.4 Renal Tubules 1.5 Renal Interstitium 1.6 Renal Vessels 1.7 Immunofluorescence and Immunohistochemistry 1.8 Electron Microscopy 1.9 Renal Biopsy Reporting 1.10 Distribution of Lesions in Renal Biopsy (Fig. 1.4) 1.11 Tubular Changes (Fig. 1.5) 1.12 Extent of Glomerular Involvement (Fig. 1.6) 1.13 Morphology of Normal Glomerulus (Fig. 1.7) 1.14 Common GBM Alterations in Diseases Involving Glomeruli (Fig. 1.8) 1.15 Location of Immune Deposits in GBM (Fig. 1.9) 1.16 Fibrin Thrombi and Segmental Fibrinoid Necrosis (Fig. 1.10) 1.17 Crescents (Fig. 1.11) 2: Minimal Change Disease (MCD) Further Reading 3: Focal Segmental Glomerulosclerosis (FSGS) 3.1 FSGS (NOS) 3.2 FSGS (Perihilar Variant) 3.3 FSGS (Cellular Variant) 3.4 FSGS (Tip Variant) 3.5 FSGS (Collapsing Variant) 3.6 Secondary FSGS (Fig. 3.5) Further Reading 4: Membranous Glomerulopathy (MGN) Further Reading 5: Immune Complex-Mediated MPGN (Previously MPGN Type I) Further Reading 6: C3 Glomerulopathy 6.1 C3 Glomerulonephritis (Fig. 6.1) 6.2 Dense Deposit Disease (DDD) (Fig. 6.2) 6.3 Post-transplant Recurrent DDD (Fig. 6.3) Further Reading 7: Infection Related Glomerulonephritis (IRGN) 7.1 Post-infectious Glomerulonephritis (PIGN) (Fig. 7.1) 7.2 IgA Dominant PIGN (Fig. 7.2) Further Reading 8: IgA Nephropathy and IgA Vasculitis (Henoch–Schonlein Purpura) 8.1 IgA Nephropathy 8.2 IgA Vasculitis: Henoch–Schonlein Purpura (HSP) Further Reading 9: Alport’s Syndrome and Thin Basement Membrane Disease 9.1 Alport’s Syndrome 9.2 Thin Basement Membrane Disease Further Reading 10: Congenital Nephrotic Syndrome and Diffuse Mesangial Sclerosis 10.1 Congenital Nephrotic Syndrome 10.2 Diffuse Mesangial Sclerosis (DMS) Further Reading 11: Lupus Nephritis and Lupus Podocytopathy 11.1 Lupus Nephritis 11.1.1 Lupus Nephritis Class I (Fig. 11.1) 11.1.2 Lupus Nephritis Class II (Fig. 11.2) 11.1.3 Lupus Nephritis Class III (Fig. 11.3) 11.1.4 Lupus Nephritis Class III + V (Fig. 11.4) 11.1.5 Lupus Nephritis Class IV (Fig. 11.5) 11.1.6 Lupus Nephritis Class IV (Fig. 11.6) 11.1.7 Lupus Nephritis Class IV (Immune Complex Mediated Crescentic Glomerulonephritis) (Fig. 11.7) 11.1.8 Lupus Nephritis Class IV + V (Fig. 11.8) 11.1.9 Lupus Nephritis Class V (Fig. 11.9) 11.2 Lupus Podocytopathy Further Reading 12: Anti-GBM Disease Further Reading 13: Pauci-immune Crescentic Glomerulonephritis Further Reading 14: Postpartum Thrombotic Microangiopathy Further Reading 15: Hemolytic Uremic Syndrome (HUS) Further Reading 16: Diabetic Nephropathy Further Reading 17: Renal Amyloidosis Further Reading 18: Renal Involvement in Plasma Cell Dyscrasia 18.1 Myeloma Cast Nephropathy 18.2 Monoclonal Immunoglobulin Deposition Disease (MIDD) 18.2.1 Light Chain Deposition Disease (LCDD) 18.2.2 Heavy Chain Deposition Disease (HCDD) 18.3 Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits (PGNMID) 18.4 Monoclonal Gammopathy of Renal Significance (MGRS) Further Reading Myeloma Cast Nephropathy Light Chain Deposition Disease (LCDD) Heavy Chain Deposition Disease (HCDD) Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits (PGNMID) Monoclonal Gammopathy of Renal Significance (MGRS) 19: Cryoglobulinemic, Fibrillary, and Collagenofibrotic Glomerulopathy 19.1 Cryoglobulinemic Glomerulonephritis 19.2 Fibrillary Glomerulonephritis 19.3 Collagenofibrotic Glomerulopathy Further Reading Cryoglobulinemic Glomerulonephritis Fibrillary Glomerulonephritis Collagenofibrotic Glomerulopathy 20: Renal Involvement in Lysosomal Storage Disorders (Fabry’s Disease, Niemann–Pick Disease) and LCAT Deficiency 20.1 Fabry’s Disease 20.2 Niemann–Pick Disease 20.3 LCAT Deficiency Further Reading Fabry’s Disease LCAT Deficiency Glomerulopathy Niemann Pick Disease 21: Hypertensive Nephrosclerosis 21.1 Benign Nephrosclerosis 21.2 Malignant Nephrosclerosis Further Reading 22: Renal Sarcoidosis Further Reading 23: Renal Involvement in HIV 23.1 HIVAN 23.2 HIV-Associated Immune Complex (HIVIC) Mediated Kidney Disease Further Reading HIVAN HIV Associated Crescentic Glomerulonephritis (Immune Complex Mediated) 24: Renal Involvement in Scleroderma Further Reading 25: Warfarin-Induced Nephropathy Further Reading Appendices Appendix 1: Staining Procedures Hematoxylin and Eosin (HE) Stain Periodic Acid Schiff (PAS) Stain Masson’s Trichrome Stain (MT Stain) Periodic Acid Silver Methenamine (PSM) Stain Jones Methenamine Silver Stain Orcein Stain Congored Stain Thyoflavin-T Staining Perl’s Prussian Blue Staining for Iron Ziehl Neelsen Stain for Acid-Fast Bacilli Oil Red O Staining Direct Immunofluorescence Staining on Frozen Sections IF on Formalin Fixed Paraffin Sections Immunostaining (IHC) Transmission Electron Microscopy Appendix 2: Biological Reference Ranges