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Diagnose This (November 19, 2018)

L. Nich Cossey, MD
By L. Nich Cossey, MD

Nov 19, 2018

Rhabdomyolysis in kidney biopsy at Arkana Laboratories

What is your diagnosis? What additional stains would you like to confirm your diagnosis?

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The H&E photomicrograph shows intratubular, lightly pigmented casts with a granular to focally beaded morphology and is suspicious for myoglobin cast nephropathy. For confirmation, myoglobin and hemoglobin immunohistochemical (IHC) stains were ordered (as hemoglobin cast nephropathy has overlapping morphology). By IHC, myoglobin was positive in several intratubular casts while hemoglobin showed no significant staining within the casts. Immunofluorescence showed equal kappa and lambda staining within the casts. Upon speaking with the nephrologist the patient was found down and had a moderately increased serum CK, suspicious for rhabdomyolysis.

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Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.