Table 2 Description of kidney histo-pathological diagnosis
From: Visceral leishmaniasis due to Leishmania infantumwith renal involvement in HIV-infected patients
Patient | Case 1 | Case 2 | Case 3 | Case 4 |
|---|---|---|---|---|
Renal histology | MPGN type III | MPGN type III | Acute interstitial nephritis | MPGN type III |
Light microscopy | Diffuse hypercellularity and thickening of glomerular basement membrane. | Subendothelial and subepithelial deposits with mesangial interposition associated with basement membrane spikes | Acute interstitial nephritis: edema associated with interstitial lymphoplasmocytic infiltration in addition to mild tubulointerstitial fibrosis. | Subendothelial and subepithelial deposits and mesangial interposition associated with basement membrane spikes. |
Free Leishmania in a capillary lumen | Tubules are invaded by lymphocytes and areas of necrosis are visualized. | Interstitial granuloma. Positive PCR for Leishmania infantum in urine and in renal biopsy | ||
Positive PCR for Leishmania infantum in the renal biopsy | Glomeruli are uninvolved. Free Leishmania in a capillary lumen | |||
Immunofluorescence | Mesangial and endomembranous deposits of IgG, IgM, C3 and C1q | Fine granular deposition of IgG and C3 in the mesangium and along the peripheral capillary loops | Deposits of IgG and IgM with a mesangial pattern | Mesangial and endomembranous deposits of IgG and C3 |