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Currently filtering by tag: RBC Fragments

Diagnose This! (January 29, 2018)

What is your diagnosis? Immunofluorescence is negative.     ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​  ...

Opana

The histologic features of thrombotic microangiopathy (TMA) associated with intravenous abuse of extended-release oxymorphone hydrochloride (Opana ER) are shown in these photomicrographs. Medium-power view of an interlobular-sized artery shows severe mucoid intimal edema and associated fractured RBCs (arrow). Adjacent glomeruli show ischemic basement membrane wrinkling. A high-power view of same biopsy specimen shows near-luminal occlusion of an interlobular-sized artery secondary to severe endothelial cell swelling and mucoid intimal edema. By electron microscopy, glomerular basement membranes showed marked subendothelial electron-lucent expansion (arrow). Oral extended-release oxymorphone hydrochloride (Opana ER) is an opioid agonist that has undergone a tamper-resistant reformulation. A report by...