Diffuse proliferative lupus nephritis

This photo of Type IV lupus nephritis shows the classic "flea-bitten" appearance of the cortical surface in the diffuse proliferative glomerulonephritides. This rare nephrectomy specimen resulted because of uncontrollable bleeding following needle biopsy. Microscopically there was extensive crescent formation, as well as necrotizing vasculitis and interstitial inflammation. Despite aggressive therapy, the inflammatory process quickly claimed the contralateral kidney, and this young woman was placed on dialysis.