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Case Reports
. 2015 Sep 3;1(2):2055116915603995.
doi: 10.1177/2055116915603995. eCollection 2015 Jul-Dec.

Proliferative, necrotizing and crescentic immune complex-mediated glomerulonephritis in a cat

Carolyn Gross  1 , Rachel E Cianciolo  2 , George E Lees  3 , Cathy A Brown  4 , Jonathan D Foster  1
Affiliations
Case Reports

Proliferative, necrotizing and crescentic immune complex-mediated glomerulonephritis in a cat

Carolyn Gross et al. JFMS Open Rep. .

Abstract

Case summary: A 5-year-old cat was examined for vomiting and anorexia of 2 days' duration. Azotemia, hyperphosphatemia and hypoalbuminemia were the main biochemical findings. Serial analyses of the urine revealed isosthenuria, proteinuria and eventual glucosuria. Hyperechoic perirenal fat was detected surrounding the right kidney by ultrasonography. Histopathologic evaluation of ante-mortem ultrasound-guided needle biopsies of the right kidney was consistent with proliferative, necrotizing and crescentic glomerulonephritis with fibrin thrombi, proteinaceous and red blood cell casts, and moderate multifocal chronic-active interstitial nephritis. Owing to a lack of clinical improvement, the cat was eventually euthanized. Post-mortem renal biopsies were processed for light microscopy, transmission electron microscopy and immunofluorescence. This revealed severe focal proliferative and necrotizing glomerulonephritis with cellular crescent formation, podocyte injury and secondary segmental sclerosis. Ultrastructural analysis revealed scattered electron-dense deposits in the mesangium, and immunofluorescence demonstrated positive granular staining for λ light chains, consistent with immune complex-mediated glomerulonephritis. Severe diffuse acute tubular epithelial injury and numerous red blood cell casts were also seen.

Relevance and novel information: To our knowledge, this is the first report of naturally occurring proliferative, necrotizing and crescentic immune complex glomerulonephritis in a cat.

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Conflict of interest statement

Conflict of interest: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1
Figure 1
Serial sections of a glomerulus stained with (a) hematoxylin and eosin, (b) Periodic acid–Schiff method and (c) Masson’s trichrome. There is a segmental fibrinocellular crescent (*) and moderate hypercellularity in the mesangial and endocapillary compartments. Magnification × 400 for all photomicrographs. (d) Red blood cell casts (arrows) in collecting ducts of the renal medulla (hematoxylin and eosin; magnification ×200)
Figure 2
Figure 2
Transmission electron microscopy of (a) a glomerulus reveals scattered electron-dense deposits in mesangial and subendothelial zones. Podocyte foot processes are effaced. Bar = 2 µm. Direct immunofluorescence using antibodies against (b) immunoglobulin (Ig)G, (c) IgM and (d) IgA. Staining for IgG was equivocal whereas there was distinct granular staining with antibodies against IgM and IgA
See this image and copyright information in PMC

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