Images in Clinical Medicine

Kim Eagle, M.D., Editor

Membranoproliferative Glomerulonephritis Type 1

Reinold O. Gans, M.D., Ph.D., and Leonard G. Feld, M.D., Ph.D.

N Engl J Med 1996; 334:367February 8, 1996

• Slide

Article

Figure 1 An eight-year-old girl was found to have proteinuria and microscopic hematuria on a routine examination. A photomicrograph (Panel A) shows an enlarged, lobulated glomerulus with irregular thickened glomerular capillary walls, often with a double-contour appearance, so-called tram tracks (arrowheads); moderate mesangial expansion; and moderate hypercellularity (periodic acid–Schiff, ×20). A fluorescence photomicrograph (Panel B) discloses coarse and bulky granular deposits of C3 along the glomerular capillary wall and, to a lesser extent, in mesangial areas (×25). A transmission electron micrograph (Panel C) reveals large, subendothelial, electron-dense deposits (asterisks) and mesangial interposition (×4000). CL denotes capillary lumen, EN endothelial cell, and EP visceral epithelial cell.

Kim Eagle, M.D.

Reinold O. Gans, M.D., Ph.D.
State University of New York at Buffalo, Buffalo, NY 14214

Leonard G. Feld, M.D., Ph.D.
Children's Hospital of Buffalo, Buffalo, NY 14222