HIV-Associated Nephropathy: Light Microscopy Findings
PATHOPHYSIOLOGY HIVAN is caused by direct infection of renal epithelial cells by the HIV-1 virus, leading to viral gene expression. RNA in situ hybridization and DNA in situ polymerase chain…
Myeloma Nephropathy: Histopathologic Findings
TREATMENT Treatment of myeloma cast nephropathy centers on volume expansion, which reduces intratubular cast concentration, as well as chemotherapy (and sometimes plasmapheresis), which reduces serum free light chain concentration. The…
Myeloma Nephropathy: Pathophysiology and Clinical Findings
PRESENTATION AND DIAGNOSIS Nearly 50% of patients with myeloma cast nephropathy have acute kidney injury; the remaining cases are either subacute or chronic. A typical presentation in a patient without…
Lupus Nephritis: Renal Histopathology (Class V Lesions)
TREATMENT All patients with proteinuria, irrespective of the histologic class, should be treated with ACE inhibitors or ARBs. Hypertension should be strictly controlled. Hyperlipidemia should also be treated if present,…
Lupus Nephritis: Renal Histopathology (Classes III and IV Lesions)
In class IV (“diffuse LN”), the lesions are qualitatively similar to those of Class III but involve 50% or more of all glomeruli. In addition, there is often a more…
Lupus Nephritis: Renal Histopathology (Classes I and II Lesions)
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Lupus Nephritis: Diagnostic Criteria
DIAGNOSIS OF SYSTEMIC LUPUS ERYTHEMATOSUS The American College of Rheumatology has proposed a list of 11 clinical, pathologic, and laboratory criteria that can be used to diagnose SLE. These include:…
Amyloidosis: Histopathologic Findings
PROGNOSIS In AL amyloidosis, the prognosis depends on the degree of systemic involvement (especially cardiac involvement) and the degree to which therapy reduces free light chain production. Although AL amyloidosis…
Amyloidosis: Deposition Sites and Manifestations
Both AL and AA amyloidosis may also cause disease in other organ systems. Myocardial deposition is common, resulting in signs and symptoms of restrictive cardiomyopathy. Hepatic deposition leads to hepatomegaly…
Diabetic Nephropathy
PROGNOSIS A large study of type 2 diabetics found that the annual risk of progression from no albuminuria to microalbu-minuria was 2.0%, from microalbuminuria to macroalbuminuria was 2.8%, and from…
