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Currently filtering by tag: Thrombotic microangiopathy

Twitter Poll (December 23, 2020)

anti-brush border antibody disease, ABBA, renal pathology, Twitter Poll, arkana labs
Answer: D The histologic features of a thrombotic microangiopathy (TMA) are non-specific as to etiology and include both acute and chronic changes. Acute changes of TMA include glomeruli demonstrating mesangiolysis, endothelial swelling, as well as intracapillary fibrin thrombi, and fragmented red blood cells. Blood vessels in the acute phase will also classically show endothelial swelling along with intimal mucoid edema and entrapped schistocytes. Chronic TMA changes include glomerular basement duplication with double contour formation and arterial/arteriolar intimal fibrosis with concentric lamination (onion skinning), to name a few. All of the above are known to lead to TMA except for anti-brush...

Art of Medicine: Thrombotic Microangiopathy

Thrombotic Microangiopathy
The above painting shows a glomerulus containing capillary loop fibrin thrombi, an arteriole with onion-skinning, and acute tubular injury, findings that can be seen in thrombotic microangiopathy.  Morphologic findings of thrombotic microangiopathy that can be seen on a renal biopsy include arteriolar or capillary loop fibrin or platelet thrombi, red blood cell fragmentation within glomerular capillary loops or within arteries, mesangiolysis, endothelial cell swelling,  glomerular basement membrane duplication, mucoid intimal edema of arteries, and a myointimal proliferation surrounding arterioles (onion-skinning like reaction). Thrombotic microangiopathy (TMA) has a wide clinical differential diagnosis, which can have substantial morphologic overlap on a kidney...

Disease Week: Onco-Nephrology

Onco-Nephrology, disease week, arkana laboratories, renal pathology
Monday Onco-nephrology is a rapidly developing area of nephrology designed to help address and prevent kidney problems and the many complex issues that arise in cancer patients. AKI is a common complication in cancer patients. The highest 1-year risk of AKI was seen in patients with kidney cancer (44%), liver cancer (33%), and multiple myeloma (31.8%) in one large population-based cohort study. Patients with distant metastases were at highest risk. https://www.ncbi.nlm.nih.gov/pubmed/21767759 What is the most common glomerular pathology reported in patients with solid tumors? Minimal change disease Membranoproliferative glomerulonephritis Membranous nephropathy Thrombotic microangiopathy   Answer: Membranous nephropathy.  The incidence of cancer was significantly higher in patients with...

Diagnose This (August 5, 2019)

mesangiolysis, renal pathology, kidney biopsy stain, arkana laboratories
What is this finding in this native kidney?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​   ​...

Scleroderma

Acute kidney injury, anti-centromere antibodies, ischemia, schistoctes, scleroderma renal crisis, thrombotic microangiopathy, scleroderma
The patient is a 32-year-old African American female who presents with hypertensive urgency, positive ANA, positive anti-RNA polymerase III antibody, schistocytes on the peripheral smear, forgetfulness, and a creatinine of 2. On physical examination, the skin is tight and thickened along the face ("masked face"), back, and proximal arms. Urinalysis shows 250 mg of proteinuria and no active urine sediment. Serologies for c-ANCA, p-ANCA, dsDNA, and anti-GBM are negative. The patient has scleroderma renal crisis. Figure 1 shows an ischemic glomerulus. Figure 2 shows moderate interstitial fibrosis. From low power, the intimal edema and intimal proliferation within the arteries is...

Diagnose This (April 8, 2019)

thrombotic microangiopathy, fibrin, arkana laboratories, renal pathology, nephropathology
What is your diagnosis?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​   ​   ​ ​  ...

Diagnose This (August 27, 2018)

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