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):
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.