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Currently filtering by tag: Diabetes mellitus

Papillary Necrosis

This kidney biopsy is from an elderly adult patient with acute renal failure and a history of non-steroidal anti-inflammatory medication (NSAID) use. The dominant finding is papillary necrosis, which has two broad etiologies: medullary ischemia and nephrotoxic agents. Medullary ischemia may occur in patients with diabetes, sickle cell anemia, severe arteriolosclerosis, and volume depletion. Nephrotoxic agents associated with papillary necrosis include NSAIDs and phenacetin. It is not possible to know the extent of involvement based solely on core biopsies. The presence of anuria in such a clinical setting would suggest the possibility of diffuse, bilateral disease.

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...

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....

Eosinophil-Rich Inflammation in Diabetic Glomerulopathy

These photomicrographs are from a patient with diabetic nephropathy as evidenced by the Kimmelstiel-Wilson nodules in the glomerulus present on the PAS section. A patchy, interstitial inflammatory infiltrate rich in eosinophils is present, as seen in the H&E stained section. The infiltrate is particularly prominent in areas of fibrosis. No tubulitis is identified in the biopsy. Interstitial inflammation rich in eosinophils is a common finding in diabetic nephropathy. When present, the pathologist is forced to determine if the inflammation warrants a diagnosis of acute interstitial nephritis. This is an important distinction because, if interstitial nephritis is present, the clinician must...