A 64-year-old man with a 10-year history of multiple myeloma presents with progressive lower extremity edema. Vital signs show BP 142/88, HR 88, RR 16, Temp 37.2°C. Urinalysis reveals massive proteinuria (8.5 g/24 hours) without hematuria. Serum creatinine is 2.1 mg/dL. Kidney biopsy demonstrates amorphous eosinophilic deposits displaying apple-green birefringence under polarized light after Congo red staining. Which of the following best explains these renal findings?
- A)Subepithelial immune complex deposition due to anti PLA2R antibodies
- B)Extracellular deposition of misfolded proteins in beta pleated sheetsGABARITO
- C)Linear deposition of immunoglobulin along the basement membrane
- D)Loss of negative charge in the glomerular basement membrane due to cytokines
- E)Mutation of a slit diaphragm structural protein
Explicação
Renal amyloidosis causes nephrotic syndrome because misfolded proteins deposit extracellularly in beta pleated sheet configuration and disrupt normal glomerular filtration. In plasma cell dyscrasias, the deposited protein is often AL derived from immunoglobuli... Ver explicação completa e trilha adaptativa →