Renal Digest
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    Thin glomerular basement membrane disease (TBMD)


Differential diagnosis:
Hereditary nephritis and Alport's syndrome
Minimal change disease
Lupus nephritis, class I
Immunoglobulin A (IgA) nephropathy, with no lesion by light microscopy

Immunofluorescence:   

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Glomerulus showing delicate capillary loops and no significant hypercellularity; PAS, 400x
Glomerulus with no distinct histologic abnormalities; PAS, 400x
Example of GBM measurements by the method of orthogonal intercepts: the membrane is measured at the points of intersecting with superimposed grid, from the epithelial towards the endothelial side of the membrane; EM, 11,000x
Thin glomerular basement membrane disease; EM, 7,100x
Very thin glomerular basement membranes; average thickness about 180 nm; EM, 5,600x
Thin basement membrane disease, with average GBM thickness less than 264 nm; EM, 3,500x
The GBMs show segmental irregularities in thickness, but are overall very thin; EM, 5,600x
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