Renal Digest
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    Postinfectious glomerulonephritis, acute diffuse proliferative


Differential diagnosis:
Lupus nephritis, focal (class III)
Membranoproliferative glomerulonephritis (MPGN), idiopathic, type I
Immunoglobulin A (IgA) nephropathy, proliferative type

Immunofluorescence:   

      In acute phase, there is strong coarse granular C3 reactivity, with usually less intense immunoglobulin (most commonly IgG) deposition. Lack of significant immunoglobulin reactivity may be seen in many cases. Three patterns of immunofluorescence reactivity have been described: starry sky (discrete random granules), garland (confluent subepithelial granular and band-like deposits), and mesangial pattern (usually during resolving phase).
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Acute diffuse proliferative postinfectious glomerulonephritis. Diffuse global hypercellularity due to infiltration of lymphocytes and neutrophils; H&E, 200x
Extensive hypercellularity due to a presence of mixed inflammatory infiltrate (lymphocytes and many neutrophils)
Cellular crescent and endocapillary proliferation
Intense interstitial inflammation and glomerular hypercellularity, H&E, 200x
Global glomerular hypercellularity (mesangial and endocapillary) and periglomerular interstitial inflammatory infiltrate
Aggresive form of postinfectious GN, with extracapillary (crescents) and endocapillary proliferative changes and marked interstitial inflammation
Cellular crescent and endocapillary proliferation
Numerous inflammatory cells within the capillary loop
Large subepithelial `hump`-like electron dense deposit
`Hump`-like subepithelial electron dense deposit
Subepithelial `hump`-like electron dense deposit. Note complete effacement of foot processes overlying the deposit
Coarse granular staining for C3 predominantly along the capillary loops
Coarse granular staining for IgG predominantly along the capillary loops
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