drswapna
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A renal pathologist examining the day's kidney biopsies notes that one
biopsy shows amorphous red nodules within the glomerular mesangium in
hematoxylin and eosin stained material. Congo red stain of the biopsy
demonstrates apple-green birefringence of these nodules. These nodules
are most likely to be related to which of the following?
A. Acute urinary tract infection
B. Diabetes mellitus
C. Sarcoidosis
D. Systemic lupus erythematosus
E. Tuberculosis
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| skyhigh
Forum Guru
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e
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| Doc2378
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E. TB
Amyloid deposition can be secondary to Chronic Infections (choice E) and Chronic Inflammations (Choice D.)...but I think SLE has more of a diffuse profiferative DNA-anti dNA 'lumpy-bumpy' pattern in the kidneys...rather than the 'golf-ball' look.
Anybody else?
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| reet
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i agree E.
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| sturge_weber
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why not d
even diabetes mellitus can cause amyloid deposition and even sle, and even t.b
but diabetes will occur in the affernt arterioles and the effernet
but sle could occur in the mesangium
so i go with d
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| drswapna
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WOW all of you got it right
E. Glomerular nodules may be either the Kimmelstiel-Wilson nodules of diabetes mellitus or may be composed of amyloid. An amyloid origin can be confirmed by staining with Congo red, which causes the nodules to stain red with ordinary light but exhibit a distinctive "apple-green" birefringence when viewed with polarized light. The most common type of amyloid (type AA) is due to deposition of altered immunoglobulin light chains and is seen in diseases with chronic antigenic stimulation, such as tuberculosis.
Acute urinary tract infection (choice A) is an infection of too short a duration to cause amyloidosis.
Diabetic mellitus (choice B) is associated with glomerular nodules called Kimmelstiel-Wilson nodules, but these will not show apple-green birefringence when viewed with polarized light.
Sarcoidosis (choice C) typically involves the lymph nodes, lungs, spleen, and to a lesser extent, the skin and eye. It is unrelated to amyloidosis.
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| sturge_weber
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well this is the second time i got it wrong,
hope wont get it wrong again
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| Lim
Forum Elite
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Kimmelstein wilson deposion is different from AA,which is amyloid(light chains)?
that(KW depositon) is composed of just collagen?
thanks in advance.
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