A 63 year old man with long standing rheumatoid arthritis develops generalized edema and frothy urine. Urinalysis shows heavy proteinuria. Serum creatinine is mildly elevated. Renal biopsy demonstrates amorphous eosinophilic extracellular deposits that show apple green birefringence under polarized light after Congo red staining. Which of the following is the most likely diagnosis?
- A)Membranoproliferative glomerulonephritis
- B)Focal segmental glomerulosclerosis
- C)AA amyloidosis involving the kidneyGABARITO
- D)Acute interstitial nephritis
- E)Minimal change disease
Explicação
AA amyloidosis involving the kidney is correct. Chronic inflammatory states such as rheumatoid arthritis increase serum amyloid A protein, which can deposit in the kidney and cause nephrotic range proteinuria. Congo red positivity with apple green birefringenc... Ver explicação completa e trilha adaptativa →