Renal pathologists may throw out the term “full house” immunostaining…what does this mean?
This means quite simply that all five major immunofluorescent stains on a renal biopsy (IgM, IgG, IgA, C3, and C1q) are all positive. The analogy holds true in that the “full house” in cards (3 of a kind plus a pair, to the left) is similar to the 3 types of immunoglobulins plus 2 types of complement which show positive staining.
The classic situation for “full house” immunostaining occurs in lupus nephritis, in which there is immune complex deposition in the subendothelium and subepithelium.
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We have a patient with full house immunostaining who does not have typical clinical features of lupus or serology. what is the differential?