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Diagnose This! (June 19, 2017 )

What’s your diagnosis in this renal transplant?     ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​  ...

Minimal Change Disease and New Onset DM type I

AN ODD COINCIDENCE? OR ARE THEY RELATED? This biopsy is from a teenager who had a viral illness 6 weeks ago. Five weeks ago, he developed polyphagia and polydipsia and was found to have new onset Type I Diabetes Mellitus. One week prior to renal biopsy, he had the sudden onset of facial edema and a urine protein/creatinine ratio of 7.8. Image 1. No change by light microscopy. Image 2. Diffuse and complete foot process effacement. Diagnosis: Minimal Change Disease Simultaneous occurrence of Type 1 Diabetes and Minimal Change Disease has been reported. Here is a link to a case...

Arkanines: Tink

Meet Tink! He's pictured here snuggled up with one of his older brothers, Gunner. Tink belongs to Andrea who is a part of our billing team in Minnesota.

Arkanines: Penny

Have you ever seen a sweeter face? Meet Penny. She's a lab mix puppy who daily gives her older brother a hard time. She belongs to Chassity, who works with our marketing team.

Karyomegalic Nephropathy

This kidney biopsy from a 41-year-old male with CKD is remarkable for the enlarged and pleomorphic tubular nuclei with focal intra-nuclear clearing. These findings are characteristic of karyomegalic nephropathy. Karyomegalic nephropathy is a rare etiology of progressive renal failure typically presenting in the third decade of life that has been linked to mutations in FAN1, a gene involved in DNA damage repair.1 Karyomegaly is not limited to the kidneys and has been described in other organs including brain, thyroid, lung, esophagus, arteries, among others.2 References: 1. Zhou W, Otto EA, Cluckey A, et al. FAN1 mutations cause karyomegalic interstitial nephritis,...

Thrombotic Microangiopathy

The image (trichrome stain) shows the characteristic arteriolar lesion of acute thrombotic microangiopathy. Note the prominent mucoid intimal edema and extensive red blood cell fragmentation. The differential diagnosis based on this morphologic lesion is broad, and it includes infection, accelerated hypertension, antiphospholipid antibody syndrome, and malignancy, among others. The kidney biopsy was from a 75-year-old Caucasian woman seen in consultation for acute renal failure and hypertension which developed one week after the onset of severe diarrhea. Laboratory tests showed microangiopathic hemolytic anemia, and stool cultures were positive for Shiga toxin-producing E. coli. Hepatitis, ANA, anti-glomerular basement membrane, and ANCA tests...

FedEx Rowing Practice

The River Cities Dragon Boat Festival is THIS Saturday! Since our friends at FedEx are helping us row this year, Shawana is showing them the ropes. Don't forget to bring cash for the bake sale we'll have at our tent!

Pushing Glass (June 13, 2017)

A 69-year-old African American woman had a kidney biopsy due to CKD III-IV. Her medical history is significant for morbid obesity, diabetes mellitus (>5 years), hypertension (>5 years), coronary artery disease status post stent, hypothyroidism, gout and chronic kidney disease. Her renal ultrasound shows an unremarkable simple left renal cyst and increased echogenicity in both kidneys. Investigations show serum creatinine which has increased to 4.9 mg/dl. Proteinuria is up to 3.7 gm/day. Serological studies are negative. The images are characteristic findings of which of the following: 1. Sarcoidosis 2. Acute Tubular Injury 3. Uric Acid Nephropathy 4. Interstitial Nephritis 5....