Anti-glomerular basement membrane disease superimposed on membranous nephropathy: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Anti-glomerular basement membrane disease is a rare autoimmune disorder characterized by pulmonary hemorrhage, crescentic glomerulonephritis and the presence of circulating anti-glomerular basement membrane antibodies. The simultaneous occurrence of both anti-glomerular basement membrane disease and membranous nephropathy is rare.</p> <p>Case presentation</p> <p>A 59-year-old Hispanic man presented with acute onset of nausea and vomiting and was found to have renal insufficiency. Work-up included a kidney biopsy, which revealed anti-glomerular basement membrane disease with underlying membranous nephropathy. He was treated with emergent hemodialysis, intravenous corticosteroids, plasmapheresis, and cyclophosphamide without improvement in his renal function.</p> <p>Conclusion</p> <p>Simultaneous anti-glomerular basement membrane disease and membranous nephropathy is very rare. There have been 16 previous case reports in the English language literature that have been associated with a high mortality and morbidity, and a very high rate of renal failure resulting in hemodialysis. Co-existence of membranous nephropathy and anti-glomerular basement membrane disease may be immune-mediated, although the exact mechanism is not clear.</p

Glycol methacrylate embedding for light microscopy: Basic principles and trouble-shooting

Acrylic resin mixtures are now widely used as embedding media for the preparation of tissue sections. Most of these mixtures are based on 2-hydroxyethyl methacrylate (glycol methacrylate, GMA). Resin embedding preserves tissue components far better than paraffin, celloidin or frozen sections. The present review describes the basic principles and trouble shooting, in particular: the chemical and physical properties of GMA, and components used for GMA mixtures; fixation of tissues for resin embedding; methods for dehydration; microtomy; stretching on water and mounting in relation to the final dimensions of GMA sections; staining of GMA 3embedded tissue sections; and the use of GMA resins in immunohistochemistry. In addition, standard, step by step procedures for embedding tissues in GMA is included