Membranous Nephropathy 3

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Across
  1. 2. De novo MGN in renal allograft typically occurs ______ than recurrent MGN. (5)
  2. 4. By light microscopy, HBV MGN frequently exhibits mesangial hypercellularity and may exhibit endocapillary proliferation, large “wire-loop” subendothelial deposits, and/or overlapping features with MPGN types I and III. Immunofluorescence may reveal “full house” staining for immunoglobulins and complement, and mesangial and subendothelial deposits are commonly encountered on ultrastructural evaluation. Similarly, ultrastructural evaluation revealed mesangial and subendothelial deposits and endothelial tubuloreticular inclusions in 50%, 68%, and 13% of patients, respectively. All suggest HBV MGN is similar to ______ nephritis. (5)
  3. 6. HCV ___ has only rarely been documented within glomeruli of patients with HCV MGN. (3)
  4. 9. Histologic findings in all organs in IgG4-Related Disease typically include a dense lymphoplasmacytic infiltrate rich in IgG4-containing plasma cells and __________ fibrosis. (9)
  5. 10. The association of captopril and MGN has been ascribed to the presence of an active________ group, a finding that captopril shares with penicillamine and bucillamine but not with other ACE inhibitors. (10)
  6. 11. Recent literature suggests that staining for PLA2R is a useful tool to distinguish recurrent and de novo MGN in the allograft (347). These investigators stained 12 biopsies from 11 patients with recurrent MGN and 12 biopsies from 11 patients with de novo MGN with antisera to PLA2R on paraffin sections. Ten of twelve (83%) cases of recurrent MGN had positive PLA2R reactivity in the distribution of the subepithelial deposits, compared to only ____ of 12 (8%) cases of de novo MGN. (3)
  7. 13. Multiple therapeutic agents have been implicated in the development of MGN, most notably ____, penicillamine, mercury, captopril, and the NSAIDs. (4)
  8. 16. Among 48 patients with __________malignancies (i.e., carcinomas), 33 (69%) had MGN. For comparison, among the remaining 86 patients with alternative forms of neoplastic disease including Hodgkin disease, non-Hodgkin lymphoma, leukemia, embryonal tumors, and benign epithelial neoplasms, only 13 had MGN (15%). (10)
  9. 18. Renal injury is not uncommon in bone marrow and stem cell transplantation and has diverse potential etiologies. In the acute phase, there may be renal failure due to chemotherapy, antibiotics, sepsis, tumor lysis syndrome, and/or radiation. In the chronic phase, the most common injury is a form of graft versus host disease (GVHD) with features of thrombotic microangiopathy. In addition, some patients with GVHD develop immune complex-mediated glomerular disease presenting as nephrotic syndrome with biopsy findings of ______. (3) (abbrev)
  10. 20. Renal biopsy findings that suggest a diagnosis of RVT in patients with nephrotic syndrome. In patients with RVT, glomeruli often appear enlarged and congested, with focal intracapillary neutrophil___________ and fibrin thrombosis. Another helpful finding is a disproportionate degree of interstitial expansion, owing to edema and/or fibrosis. Acute tubular injury and chronic tubular atrophy are also frequent accompaniments. (11)
Down
  1. 1. The renal manifestations of sarcoidosis include ___________ interstitial nephritis, nephrolithiasis, nephrocalcinosis and MGN. (13)
  2. 3. in general is thought to have an adverse impact, a negative impact on prognosis also due to nonselective proteinuria and higher urinary levels of IgG and beta-2-microglobulin. Not surprisingly, serum anti-PLA2R antibody levels also carry prognostic significance, as declining levels often coincide with entry into clinical remission. (5)
  3. 5. HBV-associated MGN (HBV MGN) is mainly an international disease with predominance in__________.(8)
  4. 7. Differential diagnosis of proteinuria in Hashimoto thyroiditis includes rare reports of minimal change disease, FSGS, MGN, IgAN, and _________. (11)
  5. 8. The largest single-center experience with ______-associated MGN comes from the Mayo Clinic. Over a 20-year period from 1975 to 1995, 125 patients had renal biopsy findings of early (stage I to II) MGN. Criteria for _______-associated MGN included (a) onset while taking an ______; (b) exclusion of other secondary causes of MGN; and (c) rapid remission following ______ withdrawal. (5) (abbrev)
  6. 12. MPGN, with or without associated type II cryoglobulinemia, is the most frequent pattern of renal disease seen in patients with HCV infection. Additional patterns of glomerular disease associated with HCV include mesangial proliferative GN, diffuse proliferative GN, _________GN, immunotactoid glomerulopathy, and MGN. (10)
  7. 14. Urinary losses of anticoagulant factors such as heparin cofactor anti-________-III may explain the predisposition for thrombosis at the level of the renal vein, prior to dilution with the systemic venous circulation. (8)
  8. 15. Over the last four decades, numerous case reports have described MGN associated with autoimmune thyroiditis, including Graves disease and _________ thyroiditis. (9)
  9. 17. Light microscopic, immunofluorescence, and electron microscopic findings in malignancy-associated MGN are largely identical to primary MGN. A possible exception is that a single study reported an increased inflammatory cells in the________ in malignancy-associated MGN as compared to primary disease. (9)
  10. 19. The most common pattern of glomerular disease is MGN, particularly in infants with congenital _______. (8)