|
Disease | Clinical manifestations | Light microscopy | Immunofluorescence microscopy | Electron microscopy |
|
Diabetic nephropathy | Long duration of diabetes | Mesangial nodular sclerosis; PAS (+); silver (+) | Linear deposition of immunoglobulin (Ig) G, with or without IgM and C3 in sclerotic nodules | Mesangial expansion; diffuse GBM thickening; nonspecific fibrillar deposition |
|
Membranoproliferative glomerulonephritis | Chronic nephritis, nephrotic syndrome, hypertension, hypocomplementemia | Mesangial nodular sclerosis; mesangial insertion; double contouring; PAS (+); silver (+) | Granular deposition of multiple immunoglobulin deposition and complement components | Subendothelial (type I), intramembranous, often ribbon-like or nodular (type II), subepithelial (type III) electron-dense deposits |
|
Renal amyloidosis | Chronic infection, systemic amyloidosis, lymphoproliferative disease, long-term dialysis, family inheritance | Mesangial nodular sclerosis; Congo red (+) | Light chain (+) in the mesangium, GBM, tubulointerstitium, and blood vessel wall | Amyloid fibrils (randomly oriented, nonbranching, 9−11 nm in diameter) |
|
Monoclonal immunoglobulin/light chain deposition disease | Ageing, plasma cell dyscrasia, idiopathic | Mesangial nodular sclerosis; PAS (+); silver (−) | Monoclonal light chain (+) in the GBM, TBM, and vascular wall basement membranes | Granular, powdery deposits |
|
Type III collagen glomerulopathy | Persistent proteinuria, nephrotic syndrome | Mesangial nodular sclerosis; PAS (weak +) | Collagen III (+) | Parallel collagen fibers (100 nm in diameter) |
|
Fibronectin nephropathy | A rare autosomal dominant disease, nephrotic syndrome | Mesangial nodular sclerosis; PAS (+); Congo red (−) | Fibronectin (+) | Granular deposits with short fibers (10−14 nm in diameter) |
|
Cryoglobulinemia glomerulosclerosis | Proteinuria, nephrotic syndrome, high serum cryoglobulins, lymphoproliferative disorders | Intracapillary proliferation and inflammatory cell infiltrates, intracapillary thrombi, nodular glomerulosclerosis; double contouring; PAS (+) | Monoclonal or polyclonal immunoglobulin (IgM, IgG and C3), rheumatoid factor | Organized electron-dense deposits (microtubular, 30 nm in diameter) |
|
Idiopathic nodular glomerulosclerosis | Smoking, long-standing hypertension; normal glucose metabolism | Similar to those of nodular diabetic glomerulosclerosis, | IgG and albumin | No electron-dense or fibrillar deposits |
|