Now. Stop there.
And now let's move on to non
streptococcal acute Glomerulonephritis.
May be a result of non
streptococcal infection such as staph
and pneumococcal, Meningococcemia,
hepatitis B and C, mumps, HIV varicella
You have a lot of viruses
that are included here, EBV,
and perhaps even parasitic.
So there are many other causes
that would be rather infectious,
but it'd be non streptococcus.
In this picture,
what I'm showing you is the fallen.
What you're going to be paying attention
to is the following order
of ultra microscopic changes.
The first thing that you're always going
to do with electron microscopy
is for you to
then identify the paved road,
the smooth paved road
is always going to be your basic membrane.
Your next step is then
to measure or to identify the feet
or the foot processes
so what you will be finding when you find
your foot processes is what cell?
Take a look at visceral epithelial cells,
which is highlighted here
when you find such a deposit,
which is dark density, which you see in
electron microscopy here,
those dark densities that are underneath
the Visser epithelial cell
then represent what going to deposit
Next normal basic
membrane has a light gray appearance.
That's the smooth paved road we've been
And then what we'll do next is, well
take a look at them immunofluorescence.
The image of immunofluorescence
upon such a deposit of
gives you a granular pattern.
Well, how can distinguish this
for something that's linear?
First and foremost, take a look
at the history and then repeat repeat.
Repeat the number of images.
The one that you want to compare
this to would be your linear.
This is not linear.
This is granular.
What did the granular mean to you?
Oh, there's a mean, complex deposition.
It just happened to be
that the immune complex deposition here
for PSGN was sub epithelial.
Granular at some point,
could also mean sub endothelium.
And if there a different history, well
then it would be a different diagnosis.