A 46-year-old woman presents with acute onset hematuria and rapidly rising creatinine (baseline 0.8 mg/dL, now 3.2 mg/dL). Vital signs: BP 156/94 mmHg, HR 92, RR 18, temp 37.2°C, SpO2 98%. Urinalysis shows dysmorphic RBCs and RBC casts. She denies arthralgia or rash. Kidney biopsy demonstrates crescent formation with fibrinoid necrosis, but immunofluorescence shows minimal immunoglobulin and complement deposition. Which mechanism most likely explains this disease process?
- A)Pauci immune small vessel vasculitis associated with ANCAGABARITO
- B)Mesangial IgA immune complex deposition
- C)Subepithelial immune complex deposition due to malignancy
- D)Podocyte cytokine mediated foot process effacement
- E)Anti basement membrane antibody mediated injury
Explicação
Pauci immune small vessel vasculitis associated with ANCA is correct. One major category of rapidly progressive glomerulonephritis is ANCA associated vasculitis, in which crescents form despite minimal immune deposition on immunofluorescence. This contrasts wi... Ver explicação completa e trilha adaptativa →