Now, stop there, and now, let’s move on to non-streptoccocal acute glomerulonephritis.
Non-streptoccocal. Maybe result of non-streptoccocal infection
such as staph endocarditis, 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 of glomerulonephritis
that would be rather infectious but it could be non-streptoccocal.
In this picture, what I'm showing you is the following.
What you are going to be paying attention to
is the following order of optomicroscopic changes.
The first thing that always gonna do with optomicroscopy
as for you to then identify the paved road.
The smooth paved road is always going to be your basement 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?
Good. Take a look at visceral epithelial cell which is highlighted here.
When you find such a deposit which is dark density, which you see in optomicroscopies here,
those dark densities that are underneath the visceral epithelial cell
then what represent what kind of deposit? Sub-epithelial.
Next, normal basement membrane has a light gray appearance
that’s the smooth paved road that we’ve been referring to,
and then what we’ll do next is, well, take a look at the immunofluorescence.
The immunofluorescence upon such a deposit of immune-complexes gives you granular pattern.
Well, I can distinguish this from 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 wanna compare this to would be your linear.
This is not linear, this is granular.
What does granular mean to you?
Oh, there’s immune-complex deposition,
it just happened to be that the immune-complex deposition here for PSGN was?
Granular, at some point it could also mean sub-endothelial.
And if there’s a different history, well, then it would be a different diagnosis.