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Minimal change disease
0%
0/130
Postinfectious glomerulonephritis
4%
5/130
Focal segmental glomerulosclerosis
5%
6/130
Rapidly progressive glomerulonephritis
2%
3/130
Membranous nephropathy
88%
115/130
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The patient’s symptoms and urine studies are indicative of nephrotic syndrome. Diffuse thickening of the glomerular basement membrane (GBM) and subepithelial spike and dome deposits are features of membranous nephropathy. Features of nephrotic syndrome include peripheral edema and proteinuria above 3.5 g per day. Membranous glomerulopathy is the most common cause of nephrotic syndrome in Caucasian adults, whereas minimal change disease (MCD) is the most common cause of nephrotic syndrome in children. Illustration A shows diffuse thickening of the capillaries and the GBM (stained black with silver) in membranous glomerulopathy. Incorrect Answers: Answer 1: MCD is characterized by the effacement of the podocytes on electron microscopy. Answers 2 and 4: Postinfectious glomerulonephritis and rapidly progressive glomerulonephritis each result in a glomerulonephritis clinical scenario characterized by hypertension and RBC casts in the urine. These are not necessarily associated with nephrotic-range proteinuria.. Answer 3: Focal segmental glomerulosclerosis is characterized by a negative immunofluorescence and non-albumin-specific proteinuria.
4.4
(11)
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