A characteristic electron microscopic feature of minimal change disease:
Ans. c (Fusion of foot processes & their effacement). (Ref. Robbin's pathologic basis of disease, 5th /935)GLOMERULAR PATHOLOGYGlomerular pathologyFeaturesAcute post-streptococcal glomerulonephritis# Nephritic syndrome# Most frequently seen in children.# Resolves spontaneously.# Peripheral and periorbital edema, hematuria, hypertension Oliguria, azotemia.LM: Glomeruli and hypercellular neutrophils, "lumpy-bumpy".EM": subepithelial humps.IF: granular patternRapidly progressive (crescentic) GNRapid course to renal failure.LM and IF: crescent moon shapeGoodpasture's syndrome (type II hypersensitivity)--Hemoptysis, hematuria.IF; linear pattern, anti-GBM antibodies.Membranoproliferative glomerulonephritisSlowly progresses to renal failureEM: subendothelial humps, "tram track".IgA nephropathy (Berger's disease)Mild disease. Often postinfectious.IF and EM: mesangial deposits of IgAAlport's syndromeSplit basement membraneCollagen IV mutation.Nerve deafness and ocular disordersNephrotic syndromeMassive proteinuria, hypoalbuminemia,Peripheral and periorbital edema, hyperlipidemia.Membranous glomerulonephritisA common cause of the adult nephrotic syndromeLM: Diffuse capillary and basement membrane thickening.IF: granular pattern.EM: "spike and dome"Minimal change disease(lipoid nephrosis)Most common cause of childhood nephrotic syndrome. Responds to steroids.LM: normal glomeruli.EM; foot process effacementFocal segmental glomerular sclerosisMore severe disease in HIV patientsLM: segmental sclerosis and hyalinosis.Diabetic nephropathyLM: Kimmelstiel- Wilson "wire loop" lesions, basement membrane thickening.SLELM: In membranous glomerulonephritis.Wire-loop lesion with subendothelial deposits
Mesangial deposits
Splitting of basement membrane
Fusion of foot processes & their effacement
Subepithelial deposits