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Systemic Lupus

Erythematosus
Henoch-Schonlein Purpura
• Consists of
– Purpuric skin lesions on the extensor surfaces
of the arms, legs and buttocks
– Abdominal manifestations – pain, vomiting
and intestinal bleeding
– Nonmigratory arthritis
– Renal abnormalities
•LM: proliferative, crescents
•IF: mesangial IgA +/- C3 and IgG
•Vasculitis in dermis and GIT
Diabetic Glomerulosclerosis
• A leading cause of ESRD
• Proteinuria in 50% 12 to 22 years after
clinical appearance of diabetes,
decresing GFR and retinopathy
• Morphology
– Diffuse glomerulosclerosis
• Diffuse increase in mesangial matrix
• Mild mesangial cell proliferation
• Overall thickening of GBM
–Nodular glomerulosclerosis
•Kimmelsteil-Wilson disease
•Pathognomic of DM
•Ovoid or spherical, often laminated, hyaline
masses situated in the periphery of the
glomerulus
•IF: Bright linear staining along the GBM and TBM
•EM: GBM thickening and increase in mesangial
matrix, often nodular
Amyloidosis
• Heavy proteinuria or nephrotic syndrome
• LM: normal, nodules, or diffuse thickening
of GBM and mesangium
• IF: non-contributory
• EM: rigid non-branching fibrils
(mesangium and GBM)
• Course: bad prognosis