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Currently filtering by tag: Intimal arteritis

Diagnose This! (October 30, 2017)

What is your diagnosis?   ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​   ​   ​ ​...

Pushing Glass (October 10, 2017)

The patient is a 50-year-old African-American female with a past medical history significant for ESRD secondary to lupus nephritis who presents two weeks after a renal transplant with a delay in graft function. Her creatinine at the time of presentation is 9. She reports feeling fine and does not have any rashes or joint discomfort. A renal biopsy is performed on the transplanted kidney. Which is the best diagnosis? A. Acute Tubular Injury B. Thrombotic thrombocytopenic purpura C. Acute Antibody-Mediated Rejection D. Vasculitis  The correct answer is c (acute antibody-mediated rejection). The biopsy shows a constellation of findings. This includes...

Diagnose This! (August 28, 2017)

What is this finding and what is the most likely etiology?     ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​...

Intimal Arteritis

The image in Figure 1 shows mild intimal arteritis in an allograft biopsy from a patient who had undergone a kidney transplant. Note that the mononuclear inflammatory cells are found beneath the endothelium rather than simply adherent to the endothelial surface, which may be seen with inflammatory cell margination. Remember, too, as reflected in the 2013 revised Banff working classification, that intimal arteritis may be seen in antibody-mediated rejection in addition to T-cell-mediated rejection. In the patient’s biopsy, the additional presence of linear C4d positivity in peritubular capillaries (Figure 2) and the absence of significant interstitial inflammation and tubulitis provided...