CLINICAL CASE and ANSWERS 38

Microfilariae associated kidney disease has been noted. What would one see on the kidney biopsy?

glomerulus revealing sheathed microfilariae in the capillary lumen micro	3 (8%)
mesangioproliferative glomerular disease	2 (5%)
membranoproliferative glomerular disease	4 (11%)
membranous glomerular disease	4 (11%)
granulomatous interstitial inflammation and eosinophils in the kidney	9 (25%)
all of the above can be seen	13 (37%)

Majority of you got this one right.  Two ways microfilariae can cause glomerular diseases: direct physical invasion and second is via an immune mediated process( would included any form of diseases but mainly MPGN, mesangioproliferative and membranous). AIN with granulomas has also been seen. As a result, all of the above are correct.
Ref:
http://www.ncbi.nlm.nih.gov/pubmed/21527949