AFRAN Nephro-Pathology Monthly Case (March 2022)
Case developed by:
Mohammed Abdel Gawad (Egypt), Rim Goucha (Tunisia), Wessam Ismail (Egypt)

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Case History: A 39-year-old woman, with history of low back pain that appearded after lifting heavy object. Ten days later she begins to develop lower limb edema and general malaise. She does not report other symptoms. At physical examination blood pressure: 130/80, HR: 79 x min, respiratory rate: 16 x min. No skin lesions. Lower limb edema. Laboratory investigations showed: creatinine: 2.2 mg / dL, BUN: 32 mg / dL (no previous values ​​are known), serum albumin: 2.3 g / dL; total protein: 5.4 g / dL. Normal CBC, ANAs, ANCAs and complement negative or normal. Negative virus studies. Urinalysis: proteins: 4+, erythrocytes: 10 / HPF. Proteinuria in 24h: 5.5 g. Protein electrophoresis without monoclonal peak. The patient was thoroughly re-interrogated and acknowledged having consumed diclofenac (self-medicated) in the previous 2 weeks due to the low back pain. See the images of the renal biopsy and differential diagnosis below then choose the most accurate answer.
Q1- What is showed in the following LM low poer section (Reference of the image: kidneypathology . com) *
1 point
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Q2- What is the seen pathology in this Methenamine-silver stain section?  (Reference of the image: kidneypathology . com) *
1 point
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Q3- What is the seen pathology in this EM section?  (Reference of the image: kidneypathology . com) *
1 point
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Q4- What is your final possible diagnosis?
1 point
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