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Low-Vacuum Scanning Electron Microscopy to Assess Histopathological Resolution of Class V Lupus Nephritis: A Case Report

Authors
  • Yoshida, Maria
  • Hirashio, Shuma
  • Doi, Toshiki
  • Masuda, Yukinari
  • Shimizu, Akira
  • Masaki, Takao
Type
Published Article
Journal
Case Reports in Nephrology and Dialysis
Publisher
S. Karger AG
Publication Date
Feb 03, 2021
Volume
11
Issue
1
Pages
36–47
Identifiers
DOI: 10.1159/000509470
PMID: 33708798
PMCID: PMC7923700
Source
Karger
Keywords
License
Green
External links

Abstract

Lupus nephritis (LN) is most frequently associated with poor outcomes in patients with systemic lupus erythematosus (SLE). LN manifests as histopathological changes in the kidney caused by immune complex formation and deposition. In particular, immunoglobulin G (IgG) deposits are frequently observed by immunofluorescence staining, which helps to establish the diagnosis of LN. In this case report, we describe a 57-year-old woman with SLE who had been undergoing treatment on an outpatient basis for 11 years. Her first and second renal biopsies revealed class V LN with a coarsely granular pattern of IgG deposition in the peripheral capillary walls. However, her third renal biopsy showed no IgG deposition, which indicated histopathological resolution of her class V LN. We used low-vacuum scanning electron microscopy (LV-SEM) to examine the three-dimensional structural alterations in her glomerular basement membranes. In this report, we describe findings that indicated resorption of epithelial deposits, that is, resolution of LN. The results of repeated kidney biopsies confirmed by LV-SEM suggested the possibility of a state unrelated to LN.

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