U07-1830

#840761421

• DM with neuropathy, retinopathy with proteinuria

• 45 YO African Canadian came in with ESOB. Crea of 1500 mmol/L

• His baseline Cr was 150 mmol/L in March 2006.• PMH: DM x 15 years. Last HgbA1C 14.5%• Lab: Anemia, Proteinuria (10 grams/day)• Reasons for Biopsy: - Fast decline of GFR- Patient believes!…………………And Biopsy showed……………….

IF• IgG- Negative.• IgA- Negative.• IgM- Moderate vascular staining. Moderate staining of glomerular

hyalinosis lesions.• C3- Mild to moderate vascular staining. Mild to moderate staining

of hyalinosis lesions.• C1q- Mild vascular staining. • Kappa- Negative.• Lambda- Negative.• Fibrinogen- Mild staining of fibrous crescent. Mild interstitial

staining. • Albumin- Mild linear TBM staining, a common finding in diabetes.

IgM

IgM

C3

C3

Clq

Fibrin

Fibrin

Albumin

EM

• Is pending

DiagnosisRenal Biopsy:• Nodular diabetic glomerulosclerosis with

extensive parenchymal scarring and atrophy and glomerular scarring nearing end-stage disease.