Advance Diabetic Nephropathy |
DM (+). |
TMB and GBM thickening, mesangial expansion, non-isometric Kimmelstiel-Wilson nodules, afferent and efferent arterioles hyalinosis. |
Negative. Linear accentuation of GBM and TMB for IgG and albumin. |
Mesangial matrix and cellularity increase, diffuse TMB and GBM thickening, diffuse foot process effacement. |
Membrano-proliferative Glomerulonephritis |
Etiology dependent. |
Endocapillary proliferation, lobular accentuation, diffuse GBM thickening with double contour. |
Diffuse granular GBM and mesangial staining of IgG (polyclonal or monoclonal); Dominant or only C3. |
Mesangial and subendothelial granular deposits. |
ING or SHaNGS |
Smoking and Hypertension, DM History (-). |
Mesangial matix expansion with nodular appearance, GBM thickening, arteriolar hyalinosis and glomerulomegaly. |
Negative. Linear accentuation of GBM and TMB for IgG and albumin. |
Negative. Linear accentuation of GBM and TMB for IgG and albumin. |
Amyloidosis |
Etiology dependent. |
Acellular, amorphous, pale-pink material in mesangium, GBM, interstitium and arteries. Congo Red, positive apple-green birefringence. |
Restricted monoclonal light chain staining. |
Randomly oriented, non-branching, straight fibrils (8–12 nm in diameter) and foot process effacement. |
Fibrillary Glomerulonephritis |
Unknown etiology. |
Nodular and membrano-proliferative appearance. Congo red-negative. |
Polyclonal IgG (IgG4) and C3 staining. |
Randomly oriented, non-branching, straight fibrils (12–24 nm in diameter) in mesangium and GBM. |
Immunotactoid Glomerulonephritis |
Nodular and membrano-proliferative appearance. Congo red-negative. |
Nodular and membrano-proliferative appearance. Congo red-negative. |
Monoclonal IgG with kappa or lambda light chain staining. |
GBM and mesangial microtubular deposits in parallel arrays (>30 nm in diameter). |
GBM and mesangial microtubular deposits in parallel arrays (>30 nm in diameter). |
Paraprotein in blood and/or urine. |
Mesangial expansion with nodular appearance. |
Restricted monoclonal linear light and/or heavy chain staining in mesanguim, TMB and GBM. |
Finely granular or “pepper-like” appearance deposits in TMB outer part and GBM inner part. |
Type III Collagen Glomerulopathy |
Blood and urine N-terminal procollagen type III peptide. |
May be hypercellular. |
Negative. |
Curved fibers with 60 nm periodicity. |
Fibronectin Glomerulopathy |
Family history. |
PAS positive mesangial deposits. |
Negative, except for fibronectin staining. |
Massive electron-dense deposits in mesangial matrix. |
Chronic Cyanotic or Ischemic Conditions |
Etiology dependent. |
Centrolobular mesangial thickening, hyaline mosaic pattern deposition, mesangiolytic lesions, glomeruli microaneurysms and arterioles hyaline deposition. |
Negative |
Intramembranous and mesangial electron-dense deposits. |