In anti-GBM (Goodpasture) disease, immunofluorescence of the kidney shows a characteristic pattern of IgG staining. Which pattern is pathognomonic?

• A Granular 'lumpy-bumpy' deposits along the GBM
• B Mesangial IgA deposits
• C Subepithelial 'spike and dome' pattern
• D Linear IgG staining along the entire GBM ✓

Explanation

Anti-GBM disease (Goodpasture syndrome) is characterized by linear IgG staining along the entire glomerular basement membrane on immunofluorescence, due to autoantibodies targeting the alpha-3 chain of type IV collagen. Granular deposits indicate immune complex deposition (lupus, post-infectious GN). Mesangial IgA is IgA nephropathy. 'Spike and dome' is membranous nephropathy on EM.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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