Renal biopsy in a woman who died of eclampsia shows enlarged, pale glomeruli with marked swelling of glomerular capillary endothelial cells and narrowing of capillary lumina. Which lesion is this?

• A Focal segmental glomerulosclerosis
• B Glomerular capillary endotheliosis ✓
• C Membranous nephropathy with subepithelial deposits
• D Crescentic glomerulonephritis

Explanation

The classic renal lesion of pre-eclampsia and eclampsia is glomerular capillary endotheliosis: swelling of endothelial cells with fibrin deposition beneath them, producing enlarged, bloodless looking glomeruli. It is entirely reversible after delivery. Focal segmental glomerulosclerosis shows segmental scarring and hyalinosis, membranous nephropathy shows thickened basement membrane with subepithelial immune deposits, and crescentic disease shows cellular crescents in Bowman space. None of these produce the diffuse endothelial swelling described here.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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