Minimal change disease immunohistology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian
Overview
A kidney biopsy is not routinely performed as soon as nephrotic syndrome is found during lab work-up. According to the National Kidney Foundation (NKF) Kidney Disease – Improve Global Outcomes (KDIGO) guidelines in 2012,[1] an initial attempt using corticosteroids should be performed before a renal biopsy is performed. A renal biopsy of minimal change disease shows no abnormalities on light microscopy. Lipid-laden cells may be seen in proximal tubular epithelium. Renal biopsy is often unremarkable under immunofluorescence, with the exception of few cases that stain positively for IgM antibodies and C3.[2]
Immunohistology
Light Microscopy
A renal biopsy of minimal change disease shows no abnormalities on light microscopy. Lipid-laden cells may be seen in proximal tubular epithelium. Additional features of focal segmental glomerulosclerosis, such as mesangial prominence, interstitial fibrosis, and tubular atrophy, or glomerular tip lesions of FSGS, may be seen in patients who have complicated disease.[2] Those with acute renal injury may have histological features of focal flattening of the proximal tubular epithelium.[2]
Immunofluorescence
Renal biopsy is often unremarkable under immunofluorescence, with the exception of few cases that stain positively for IgM antibodies and C3.[2]
References
- ↑ Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH; et al. (2013). "KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis". Am J Kidney Dis. 62 (3): 403–41. doi:10.1053/j.ajkd.2013.06.002. PMID 23871408.
- ↑ 2.0 2.1 2.2 2.3 D'Agati V (2003). "Pathologic classification of focal segmental glomerulosclerosis". Semin Nephrol. 23 (2): 117–34. doi:10.1053/snep.2003.50012. PMID 12704572.