Arkana Labs

Needle Core Biopsy Muscle Clinical History:This 50-year-old patient presented with progressively worsening muscle weakness of one month duration. Their past medical history was significant…

The answer is: Necrotizing Myopathy

To learn more, head to our blog: www.arkanalabs.com/needle-core-...

#neuropath #neuromuscular #neuronotes #pathology

2/ Immunofluorescence stain for Collagen IV alpha 5 shows no GBM staining (Figure 2), but preserved Bowman's capsule staining, consistent with autosomal recessive AS. Staining for collagen IV alpha 2 confirms lack of staining along GBMs (Figure 3); nuclei are highlighted in blue DAPI staining.

1/ This electron microscopy shows marked GBM abnormalities, consistent with Alport's Syndrome (AS). The patient had genetic testing, which confirmed a COL4A3 mutation.

#renalpath #kidneypath #pathology #renal

2/ Predominantly subepithelial deposits, in contrast, would be expected in most cases of membranous glomerulopathy.  

#TeachingPoints #kidneypath #renal #pathology

1/ A well-prepared Jones methenamine silver stain can help localize immune deposits. By sharply defining the glomerular capillary basement membrane (GBM), the Jones stain confirms that the massive confluence of immune deposits is confined to the subendothelial region of the capillary wall.

Dr. Samar Hassen is also among the Arkana researchers involved with this publication!

In a 23yo M with proteinuria, hematuria and CKD, what is your diagnosis?

#DiagnoseThis #nephsky #pathsky #renal #kidneypath

Education At Arkana Laboratories, we put the education of the next generation first! We offer quizzes, a pathology fellowship, and resident rotations.

We have launched four neuropathology quizzes on our website! If you're interested in testing your neuropathology wisdom, head to our site. #neuropathology #neuromuscular #pathology #neuropath #neuronotes

The tiny fragment of glutaraldehyde-fixed tissue available for toluidine blue stained sections (image not provided) showed features similar to those seen in the FFPE tissue sections, and a few necrotic myofibers.

The provided images (low and high magnification) show the total tissue available for evaluation in the formalin-fixed paraffin embedded tissue.

The patient’s home medication list included levothyroxine. They were treated with steroid prior to muscle biopsy. A needle core biopsy was performed of the left thigh. A minute fragment of fibrous tissue was present in tissue available for frozen section.

This 50-year-old patient presented with progressively worsening muscle weakness of one month duration. Their past medical history was significant for type 2 diabetes, hyperlipidemia, hypertension and hypothyroidism. Statin medication (atorvastatin) was held upon admission.

1/ What is the best pathologic diagnosis? Clinical history in thread.

#NeuroNotes #neuropath #pathology #neuromuscularpath

This means this approach could one day be used to get a much more detailed picture of exactly how the immune system is attacking a patient's kidneys & allow for selection of the appropriate targeted treatment for each individual patient, rather than using a one-size-fits-all approach.

The key finding is that a technique called mass spectrometry can be used on kidney biopsy tissue to detect and measure dozens of these complement proteins at once, far surpassing the current standard testing methods.

This paper investigates kidney diseases caused by a part of the immune system called the "complement system" — a group of over 50 proteins that normally help fight infections, but can cause damage to the kidneys when they malfunction.

Proteomic Profiling of Complement Components in Glomerular Disease - PubMed The complement system plays a central role in glomerular disease development and resolution. Currently, renal biopsies assess the presence of complement through limited immunofluorescence stains (C3 and C1q). With more than 50 total proteins and fragments involved in the complement cascade, this met …

We're excited to share a new research publication from @aaronstorey.bsky.social, @glombandit.bsky.social, and Dr. Chris Larsen titled, "Proteomic Profiling of Complement Components in Glomerular Disease."

Read here: https://pubmed.ncbi.nlm.nih.gov/41720186/
#ArkanaResearch #RenalPath #RenalResearch

Here is today’s #eyeSCANdy! Acellular scanning EM of a normal glomerular tuft showing the subpodcocytic capillary loop basement membranes following removal of the podocytes. 

Photo courtesy of Dr. Stephen Bonsib. #renal #pathology #kidneypath

A sample from the pathology teaching slide set on Immunoglobulin and Complement-Mediated Glomerular Diseases with an MPGN Pattern of Injury, jointly prepared by Arkana Laboratories and @goKDIGO. http://KDIGO.org/guidelines/gd/

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3/ Although the donor APOL1 status is unknown, it is likely that it was a carrier of APOL1 high risk alleles, and COVID19 infection was the second hit that triggered the development of collapsing glomerulopathy in the recipient.

2/ The patient reported mild COVID19 infection two weeks prior to presentation, not requiring hospitalization.

#pathology #renal #pathsky

1/ The biopsy shows collapsing glomerulopathy, for which the differential diagnosis in a transplant recipient includes ischemia, calcineurin inhibitor nephrotoxicity, CMV infection, thrombotic microangiopathy, and donor-derived APOL1-associated nephropathy.

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This is the biopsy from a 41yo Middle Eastern female who received a renal transplant a few years prior and presents with AKI. What is your diagnosis? 

#DiagnoseThis #nephsky #pathsky #renal #kidneypath

We have officially launched four new neuropathology quizzes on our website! If you're interested in testing your neuropathology wisdom, head to our website to test your knowledge. #neuropathology #neuromuscular #pathology 

What are your diagnoses for the changes seen in the muscle biopsy (image #1) and the incidental finding that was seen in multiple blood vessels (images #2 and #3)?

Laboratory studies showed normal CPK and elevated CRP. No myotoxic medications were noted in the patient’s home medication list.

This 76-year-old male presented with complaints of muscle pain. Their past medical history is significant for Sjogren’s syndrome, fibromyalgia, peripheral neuropathy, hypertension and hyperlipidemia.

We asked Dr. Kowalewska about her path from med student to renal pathologist! Have you thought about exploring renal pathology? Check out our visitor program to begin exploring the world of renal! #path2path #roadtorenal #renalpathology #pathologist

We have officially launched four new neuropathology quizzes on our website! If you're interested in testing your neuropathology wisdom, head to our website to test your knowledge. #neuropathology #neuromuscular 

Here is today’s #eyeSCANdy! Acellular scanning EM of a normal glomerular tuft showing the subpodcocytic capillary loop basement membranes following removal of the podocytes. 

Photo courtesy of Dr. Stephen Bonsib. #renal #pathology #kidneypath