Keeping with our recent theme of “numerical rules in Nephrology”, let’s briefly discuss the “Rule of Thirds” for Membranous Nephropathy. The “Rule of Thirds” is frequently taught in medical school and a useful way of thinking about the…
A landmark paper on membranous nephropathy was published by Beck et al in the most recent issue of NEJM. Ultimately we will have to see if the finding is reproducible, but based on the data presented this represents…
We’re all taught that looking for dysmorphic red blood cells on urinalysis is a useful marker of glomerular hematuria. But how do we define “dysmorphic”? And how was this association originally studied? One landmark paper was this 1991…
I recently had to look up the differential diagnosis of nodular glomerulosclerosis: we had recently sent a clinic patient to undergo a renal biopsy based on a history of nephrotic-range proteinuria (urine protein to creatinine ratio of about…
Saw a case in the clinic today of a 40-ish year old woman who was diagnosed about a year and a half ago with Henoch-Schonlein purpura. This is notable in that usually this is a pediatric disease–though as…
Churg-Strauss Syndrome lies within the spectrum of Wegener’s Granulomatosis, microscopic polyangiitis, and ANCA-associated vasculitis: all diseases which result from inflammation of small-to-medium-sized vessels. The “classic triad” of Churg-Strauss syndrome is asthma, eosinophilia, and vasculitis, and although “renal involvement”…
The loin pain-hematuria syndrome occurs when glomerular hematuria occurs in conjunction with renal colic, in the absence of glomerulonephritis or a worsening of renal function. It is not a common disorder, though appears to be more common in…
Heard a case this morning regarding an elderly white patient who presented with nephrotic syndrome and minimal hematuria. After going through the extensive differential diagnosis, focusing largely on the likely candidates (membranous nephropathy and minimal change disease), the…
Schistosoma species–also known as blood flukes and bilharzia–can cause some interesting forms of renal disease. Although this is not so common in the United States, it is a very common public health problem in Africa and Asia. Chronic…
The finding of fibrils on electron microscopy of a renal biopsy specimen may be an extremely important clue in establishing the diagnosis. In fact, for many of the conditions listed below, the diagnosis may be based PURELY on…
