arrow-right-realarrow-right-whitearrow-rightback-to-topdoctordownloadfacebookinstagramlogo-markerlogo-wordmarkpodcastsearchsearch_whitetwitter
Close Modal

Blog


Currently filtering by tag: Tubulitis

Twitter Poll (August 7, 2019)

ANSWER: D The most common finding on kidney biopsies in patients with immune checkpoint inhibitors (ICPIs)–induced AKI is acute tubulointerstitial nephritis. Less frequently, granulomatous interstitial nephritis and TMA have also been reported. The two main ICPIs are anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and anti-programmed cell death protein 1 (PD-1). The onset of kidney injury seen with PD-1 inhibitors is usually late (3-10 months) compared to CTLA-4 antagonists-related renal injury, which happens earlier (2-3 months). PD-1 inhibitors, as opposed to CTLA-4 inhibitors, have been associated with kidney rejection in transplantation. Steroids appear to be effective in treating the immune-related adverse effects...

Diagnose This (June 17, 2019)

The image shown comes from a kidney transplant patient with a rise in serum creatinine. What is the most likely diagnosis and what immunohistochemical stain would you want to rule out a less common disease sometimes seen in kidney transplants?       ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​...

Art of Medicine: Borderline Changes for TCMR Painting

The painting above of a kidney transplant biopsy shows mild interstitial inflammation and tubulitis.   If this field is representative, these changes would be consistent with borderline changes suspicious for T cell-mediated rejection (TCMR).   A diagnosis for borderline changes suspicious for TCMR can be made with mild interstitial inflammation (i1; 10-25% of cortex) with any degree of tubulitis (i1t1 with 0-4 lymphocytes/tubular profile, i1t2 with 4-10 lymphocytes per tubular profile, i1t3 with >10 lymphocytes per tubular profile or tubular basement membrane rupture), by moderate interstitial inflammation (25-50% of cortex) with mild tubulitis (i2t1), or with isolated tubulitis without interstitial...

Polyomavirus Nephropathy in Native Kidney

Polyomavirus nephropathy (PVN), predominantly caused by BK virus reactivation in the urogenital tract, is an important complication of renal allografts (reference 1). While it rarely affects the native kidney, it may be seen in the setting of chronic immunosuppression, including bone marrow transplantation, HIV infection, chemotherapy and in the setting of other solid organ transplants (reference 2). The case shown is from a 69-year-old female with a history of sarcoidosis and cirrhosis who is now 5 years post liver transplant. The patient is currently being evaluated for a progressive increase in serum creatinine. The biopsy shows significant, non-specific tubulointerstitial scarring...