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Collapsing glomerulopathy with patchy acute cortical necrosis secondary to postpartum hemorrhage.

Kazi J, Mubarak M - Clin Kidney J (2012)

View Article: PubMed Central - PubMed

Affiliation: Histopathology Department, Sindh Institute of Urology and Tranplantation (SIUT), Karachi, Pakistan.

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Sir, Collapsing glomerulopathy (CG) represents a distinct pattern of renal response to injury characterized by segmental to global collapse of capillaries in association with hyperplasia and hypertrophy of the visceral epithelial cells (VECs) associated with marked tubulointerstitial damage... We herein report two cases of CG involving the glomeruli in the vicinity of patchy ACN found on biopsies from native kidneys in two patients... In addition, both biopsies showed variable numbers of glomeruli in the vicinity of infarction, with segmental to global collapse of capillaries associated with hyperplasia and hypertrophy of VECs (Figure 1)... A report of three cases of zonal distribution of CG in the vicinity of patchy infarction secondary to severed accessory renal vessels in the transplanted kidneys has recently been published... Similarly, occasional reports are also available in the literature, in which an association of FSGS and CG in the native kidneys with the vascular lesions has been observed... However, this is the first report of CG in association with ischaemic ACN secondary to hypovolaemia resulting from PPH in native kidneys in two young females and provides evidence for the broad etiopathogenetic pathways leading to the final common pattern of CG... We also believe that this lesion is of secondary or reactive nature, rather than primary or idiopathic CG... There is very little information in literature on the clinical behaviour, treatment and prognosis of secondary forms of CG, but these might be determined by the underlying disease... In conclusion, this report highlights the close association of ischaemia with CG and further expands the spectrum of associations of this renal lesion.

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High-power view showing a glomerulus from one of the renal biopsy specimens showing global collapse of capillary tufts associated with marked hypertrophy and hyperplasia of the podocytes. These show marked cytoplasmic vacuolization and protein resorption droplets in some cells. There is moderate tubulointerstitial inflammation in the background and one tubular lumen contains proteinaceous cast with scalloped margins (silver stain, x400).
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fig1: High-power view showing a glomerulus from one of the renal biopsy specimens showing global collapse of capillary tufts associated with marked hypertrophy and hyperplasia of the podocytes. These show marked cytoplasmic vacuolization and protein resorption droplets in some cells. There is moderate tubulointerstitial inflammation in the background and one tubular lumen contains proteinaceous cast with scalloped margins (silver stain, x400).

Mentions: Renal biopsies in both cases showed patchy infarction. In addition, both biopsies showed variable numbers of glomeruli in the vicinity of infarction, with segmental to global collapse of capillaries associated with hyperplasia and hypertrophy of VECs (Figure 1). There was moderate mixed inflammatory cell infiltration in the interstitium. However, no vasculopathy or thrombotic lesions were noted. Immunofluorescence was performed on snap-frozen tissue and showed segmental positivity of immunoglobulin M (IgM) and C3 in areas of collapsed tufts of viable glomeruli, whereas IgG, IgA and C1q were negative. Thus, both cases showed typical glomerular changes of CG involving the glomeruli in close proximity to patchy ACN.


Collapsing glomerulopathy with patchy acute cortical necrosis secondary to postpartum hemorrhage.

Kazi J, Mubarak M - Clin Kidney J (2012)

High-power view showing a glomerulus from one of the renal biopsy specimens showing global collapse of capillary tufts associated with marked hypertrophy and hyperplasia of the podocytes. These show marked cytoplasmic vacuolization and protein resorption droplets in some cells. There is moderate tubulointerstitial inflammation in the background and one tubular lumen contains proteinaceous cast with scalloped margins (silver stain, x400).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400445&req=5

fig1: High-power view showing a glomerulus from one of the renal biopsy specimens showing global collapse of capillary tufts associated with marked hypertrophy and hyperplasia of the podocytes. These show marked cytoplasmic vacuolization and protein resorption droplets in some cells. There is moderate tubulointerstitial inflammation in the background and one tubular lumen contains proteinaceous cast with scalloped margins (silver stain, x400).
Mentions: Renal biopsies in both cases showed patchy infarction. In addition, both biopsies showed variable numbers of glomeruli in the vicinity of infarction, with segmental to global collapse of capillaries associated with hyperplasia and hypertrophy of VECs (Figure 1). There was moderate mixed inflammatory cell infiltration in the interstitium. However, no vasculopathy or thrombotic lesions were noted. Immunofluorescence was performed on snap-frozen tissue and showed segmental positivity of immunoglobulin M (IgM) and C3 in areas of collapsed tufts of viable glomeruli, whereas IgG, IgA and C1q were negative. Thus, both cases showed typical glomerular changes of CG involving the glomeruli in close proximity to patchy ACN.

View Article: PubMed Central - PubMed

Affiliation: Histopathology Department, Sindh Institute of Urology and Tranplantation (SIUT), Karachi, Pakistan.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Sir, Collapsing glomerulopathy (CG) represents a distinct pattern of renal response to injury characterized by segmental to global collapse of capillaries in association with hyperplasia and hypertrophy of the visceral epithelial cells (VECs) associated with marked tubulointerstitial damage... We herein report two cases of CG involving the glomeruli in the vicinity of patchy ACN found on biopsies from native kidneys in two patients... In addition, both biopsies showed variable numbers of glomeruli in the vicinity of infarction, with segmental to global collapse of capillaries associated with hyperplasia and hypertrophy of VECs (Figure 1)... A report of three cases of zonal distribution of CG in the vicinity of patchy infarction secondary to severed accessory renal vessels in the transplanted kidneys has recently been published... Similarly, occasional reports are also available in the literature, in which an association of FSGS and CG in the native kidneys with the vascular lesions has been observed... However, this is the first report of CG in association with ischaemic ACN secondary to hypovolaemia resulting from PPH in native kidneys in two young females and provides evidence for the broad etiopathogenetic pathways leading to the final common pattern of CG... We also believe that this lesion is of secondary or reactive nature, rather than primary or idiopathic CG... There is very little information in literature on the clinical behaviour, treatment and prognosis of secondary forms of CG, but these might be determined by the underlying disease... In conclusion, this report highlights the close association of ischaemia with CG and further expands the spectrum of associations of this renal lesion.

No MeSH data available.


Related in: MedlinePlus