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Currently filtering by tag: Microcystic tubular dilitation


This biopsy is taken from a patient with HIV/AIDS who presented with an elevated serum creatinine and nephrotic range proteinuria.  Key morphologic features associated with HIV-related kidney disease include collapsing glomerular lesions, microcystic tubular dilatation and variable tubular epithelial injury, and interstitial inflammation and edema (see Fig 1-3).  In addition to these findings, other kidney diseases seen in patients with HIV include the following:  HIV immune complex kidney disease (HIVICK), various other immune complex diseases (e.g. hepatitis C virus, membranous glomerulopathy), HIV-associated lupus-like glomerulonephritis, thrombotic microangiopathy, and various renal tumors (e.g. Kaposi sarcoma, lymphoma).

Pushing Glass (May 11, 2018)

Lithium-Induced Nephropathy, kidney disease, arkana laboratories, acute renal disease
These images are from the kidney biopsy of a 45-year-old man with a history of hypertension and bipolar disease presenting with renal failure. Serum creatinine is 3 mg/dl. Which of these elements has been associated with some of the findings in this biopsy? A. Potassium B. Lithium      C. Sodium D. Antimony E. Gold Answer: B. Lithium The features seen in this biopsy are suggestive of lithium-induced nephropathy. This develops in patients taking lithium-containing medications for prolonged periods, usually 10-20 years, and can manifest decades after the medication has been stopped. It typically shows a chronic tubulointerstitial nephropathy, usually out of...

Congenital Nephrotic Syndrome

The biopsy from this 5-year-old male with nephrotic syndrome shows immature glomeruli without segmental glomerulosclerosis (Fig 1), associated with focal microcystic tubular dilatation and mild interstitial fibrosis (Fig 2).  Furthermore, electron microscopy shows diffuse epithelial foot process effacement with microvillous transformation (Fig 3).  In the setting of nephrotic syndrome presenting in utero or in early infancy, the findings are highly suggestive of a congenital nephrotic syndrome of the Finnish type.  This entity is caused by a homozygous mutation in NPHS1, which encodes nephrin.  Nephrin is a major structural protein of the glomerular filtration slit diaphragm, which links the foot processes...

IgA and APOL1

The presence of two APOL1 risk alleles, which predominantly affects population of recent African ancestry, confers up to 29x increased risk for renal disease. The morphologic manifestation of APOL1-associated nephropathy is quite variable, and includes focal segmental glomerulosclerosis (FSGS), collapsing glomerulopathy and non-specific glomerular and tubulointerstitial arterionephrosclerosis-like chronic changes (see reference). In order to develop renal disease, it is believed that carriers of two APOL1 risk alleles required either additional genetic alterations that contribute to the disease, or additional environmental risk factors. Some of these known factors include HIV infection, sickle cell disease, systemic lupus erythematosus and membranous glomerulopathy, among...