A 45-year-old woman with a 15-year history of type 2 diabetes presents with nephrotic syndrome. Vital signs: BP 154/92 mmHg, HR 88 bpm, RR 16, Temp 37°C, SpO2 98%. Labs reveal proteinuria 4.2 g/day, serum albumin 2.8 g/dL, creatinine 1.4 mg/dL, and hyperlipidemia. Urinalysis shows no hematuria. Renal ultrasound demonstrates normal kidney size. Kidney biopsy is performed. Which light microscopy finding most consistent with diabetic nephropathy?
- A)Nodular glomerulosclerosis (Kimmelstiel-Wilson lesions)GABARITO
- B)Crescent formation with fibrinoid necrosis
- C)Segmental endocapillary proliferation
- D)Spike-and-dome subepithelial deposits
- E)Eosinophilic infiltration with granulomas
Explicação
Nodular glomerulosclerosis (Kimmelstiel-Wilson lesions) consisting of PAS-positive, diastase-resistant nodules in the mesangium is pathognomonic for diabetic nephropathy. These develop from progressive glycemic control failure and characterize nodular diabetic... Ver explicação completa e trilha adaptativa →