ATLAS OF RENAL PATHOLOGY

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Dense Deposit Disease

Pathology Editor: Agnes Fogo, MD
Medical Photographer: Brent Weedman
With Assistance From the National Kidney Foundation's cyberNephrologyTM Team: Kim Solez, MD, Director; Joseph DeAlmeida, Computer Engineer; and Brenda Kalynchuk, Administrative Assistant

 
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Fig 1. Dense deposit disease is also called membranoproliferative glomerulonephritis type 2 based on the similar light microscopic findings in the two conditions. Mesangial proliferation, double countours of the glomerular basement membrane, and mesangial interposition are evident in this figure. No obvious deposits, which typically appear pink on this PAS-methenamine silver stain, are visualized. The refractile, ribbon-like appearance of the basement membrane is a clue to the correct diagnosis of dense deposit disease, which is confirmed by immunoflurorescence and electron microscopy (Jones' silver stain; original magnification, x400).
 
 
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Fig 2. Dense deposit disease stains strongly for complement in an irregular, segmental capillary wall distribution, with occasional mesangial staining. Immunoglobin staining is typically absent, indicating there are no true immune complex-type (ie, antibody-antigen) deposits (immunofluorescence with anti-C3; original magnification, x200). 
 
 
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Fig 3. Dense deposit disease also may show large, globular mesangial staining for C3, in addition to the capillary wall staining (immunofluorescence with anti-C3; original magnification, x400). 
 
 
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Fig 4. Dense deposit disease with dense transformation of the glomerular basement membrane, endocapillary proliferation and large, globular mesangial densities (transmission electron micrograph; original magnification, x4600). 
 
 
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Fig 5. Dense deposit disease showing dense transformation of virtually the entire width of the glomerular basement membrane (transmission electron micrograph; original magnification, x8000). 
 

From the Department of Pathology, Vanderbilt University Medical Center, Nashville, TN.
Address author queries to Agnes Fogo, MD, Department of Pathology, Vanderbilt University Medical Center, MCN C-3310, Nashville, TN 37232. E-mail:Agnes.Fogo@vanderbilt.edu
Am J Kidney Dis 31(2):E1, 1998 (available www.ajkd.org)
 Copyright 1998 by the National Kidney Foundation, Inc.

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