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Diagnose This (May 18 ,2020)

Diagnose This!, anti-Coagulation
The light microscopic image demonstrates acute tubular injury with numerous occlusive red blood cell casts, which, despite obtaining deeper levels, is out of proportion to the degree of glomerular injury. While a few glomeruli showed occasional red blood cells within Bowman's space, there was no evidence of overt glomerular injury or activity such as cellular crescent formation, fibrinoid necrosis, or endocapillary hypercellularity. Thus, while it is a non-specific finding, this degree of red blood cell casts without glomerular proliferation should raise the pathologist's suspicion for anti-coagulation induced nephropathy. It is essential for the pathologists to probe further into not only...