Thursday, October 18, 2012

Nodular glomerulosclerosis

Differential diagnosis for nodular glomerulosclerosis on kidney biopsy

The differential is vast but a good way to differentiate is via IF staining
If Immuno is positive, either monoclonal or polyclonal:
Think:- Monoclonal IF:- MPGN, or paraprotein related disease such as LCDD or amyloidosis
If polyclonal IF:- Immunotactoid, fibrillary,cryoglobulinemia and other organized deposits seen in fibronectin GN

If Immuno is negative( more common): 
Diabetic Nephropathy
Chronic TMA
Chronic ischemic disease or hypoxia
Smoking associated nodular sclerosis and or related to metabolic syndrome

Check out a recent quiz on eAJKD on this topic.
Check out the concept map on this to simplify.












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