Some off-beat and slightly rare cases among the routines.. Came in just 3 days to prove the versatility and non-monotonus nature of Kidney diseases!! Age-no bar. #KidneyBiopsy #RareRenal #Nephpath #RenalPathLabs #AskRenal #PathTwitter #NephTwitter #RenalPathology #PoojaMaheshwari

🔬 Spiculated intratubular casts on silver stain, Congo red positivity, and apple-green birefringence point to amyloid cast nephropathy. Paraffin IF confirmed kappa restriction despite negative routine IF. #RenalPathology #KidneyBiopsy #Amyloidosis #NephPath

19/M with exercise-induced rhabdomyolysis presenting as dialysis-dependent AKI. Kidney biopsy showed acute tubular injury with reddish-brown pigment casts. Myoglobin IHC was strongly positive, confirming myoglobin cast nephropathy. #NephPath #AKI #Rhabdomyolysis

Rare renal manifestation of malaria-associated AKI. Kidney biopsy showed collapsing glomerulopathy with severe acute tubular injury in a patient with P. vivax infection. IF negative. An uncommon but important association. #NephPath #RenalPath#KidneyBiopsy #Malaria #CollapsingGN

Two Cryoglobulinemic GN within 10 days! One showing microtubules on EM. Rare are not rare in Indian subcontinent? .. #RenalPath #Nephtwitter #PathTwitter #KidneyBiopsy #Nephpath #CryoglobulinemicGN @AskRenal

Excited for the day!! What a cool futuristic conference ⭐️✌️ #AI #Nephpath @ucsdnephrology

Trending with Trend.. बच्चा है तू मेरा.. #RenalPath #NephPath #KidneyBiopsy #TransplantBiopsy #PoojaMaheshwari #RenalPathology #Nephtwitter #Dhurandhar

🧠🩺 Renal Pathology Pearl: Lysozyme (Lysosomal) Nephropathy 📌 Often seen in CMML / monocytic leukemias
📌 Causes tubular (non-albumin) proteinuria 🔬 Light Microscopy
• Predominant tubulointerstitial injury
• Proximal tubules with eosinophilic, granular/vacuolated cytoplasm
• Interstitial inflammation ± fibrosis
• Glomeruli largely unremarkable 🧪 Immunofluorescence
• Negative for IgG, IgA, IgM
• Negative kappa/lambda
• C3 absent or nonspecific
• (If performed: strong cytoplasmic lysozyme staining in proximal tubules) 🔍 Electron Microscopy
• Proximal tubular cells packed with enlarged lysosomes
• Lysosomes contain electron-dense granular ± crystalline material
• No immune-type deposits in glomeruli or TBMs 🧩 Key clue: High UPCR low ACR → non-albumin proteinuria
🚫 Argues against AL amyloid, LCDD, PGNMID #RenalPath #NephPath #LysozymeNephropathy #KidneyBiopsy #MedEd @MayoClinicPath

New batch for online Renal Pathology Classes starting soon!!! Register now! #RenalPathLabs #nephtwitter #RenalPathology #NephrologyResidents #PathTwitter #Nephpath

A semi-quantitative grading system of pathologic features on kidney biopsies allows for monitoring response to treatment and showing disease progression. Lupus nephritis disease activity can be assessed on a renal biopsy using the modified NIH activity and chronicity indices. Indicators of disease activity include endocapillary hypercellularity, neutrophils or karyorrhexis within glomerular capillary loops, fibrinoid necrosis, hyaline deposits, cellular or fibrocellular crescents, and interstitial inflammation. Crescents and fibrinoid necrosis are weighted twice as they have a worse impact on prognosis. The scoring is based on the percentage of glomeruli with each feature in the biopsy on a 0 to 3 scale, with a score of 0 = not present, 1 = <25% glomeruli, 2 = 25-50% glomeruli, and 3 indicating >50% glomeruli. Indicators of disease chronicity include the total percentage of global glomerulosclerosis, fibrous crescents, tubular atrophy, and interstitial fibrosis. Grading the NIH activity and chronicity indices allow comparison in repeat biopsies, as well as for standardized assessment for lupus clinical trials. The criteria for the NIH activity and chronicity indices are shown in the table below and are adapted from Bajema et al, 2018 (reference below). Reporting of these indices is recommended on all kidney biopsies for patients with focal or diffuse lupus nephritis. #lupusawareness #lupus #kidneypath #nephpath

Our very own dynamic Radhika Krishna Patil, Vice President Basic Sciences ISOT spoke on T CELL MEDIATED REJECTION & POST Tx INFECTIONS at #ISOT2024 If you missed it do check out ISOT you tube channel for the recording. If you are nephpath enthusiast do check out her latest book

Fantastic book and go to book for nephpath. Great resource #ISOT2024

Apart from MCD/FSGS/PIGN/DDD-we get pediatric renal cases with following diagnosis: IgAN, SLE, TMA, ANCA GN. What is common at your centre?? #RenalPath #PediatricRenal #NephPath #AskRenal #RenalPathSociety #AskRenalPath #PathTwitter #PoojaMaheshwari #Nephropathologist

Happy Valentine´s day ♥️ #nephpath @Renalpathsoc @arkanalabs

DIF is a saviour, not only for Kidney biopsies, but also for some GI biopsies. This one was done on a GI biopsy block after pepsin digestion (DIF-P). Turned out to be a Primary Amyloid-Kappa. #PathTwitter #GIPath #DIFonParaffinBlock #DIF #Nephpath #NephTwitter #Amyloid

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤: 65-year-old female with a renal mass. H&E sections shown: #PathTwitter #pathology #GUpath #nephpath #renalpath

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤: Transplanted kidney biopsy in a 50-year-old female. H&E sections shown: #PathTwitter #GUPath #nephpath #pathology

The quiz is on! @RenalPathLabs quiz. #RenalPath #AskRenal #AskRenalPath #NephPath #NephTwitter #RenalPathSociety

Re-structuring Glom 3D view- #collapsing #FSGS 27pics spaning 90 microns 38Y M, nephrotic synd, renal fail DIF-Neg #renalpath #nephpath #nephjc #Nephpearls #glomerulonephritis @RenalFellowNtwk @Renalpathsoc #renalbiopsy Prev cases-

Neph needs to incorporate new methods/skills for the best plan of care. POCUS is the way to go. We always get consults about vol related dz 100x than GN dz, and yet we spend more time learning all the zebras on nephPath and GN which is less than 5% of our practice!