Acute kidney injury with cryoglobulinemic peritubular neutrophilic capillaritis

M. L. Troxell; D. V. Shackleton; P. Raguram; D. C. Houghton

doi:10.5414/CN106626

Acute kidney injury with cryoglobulinemic peritubular neutrophilic capillaritis

M. L. Troxell, D. V. Shackleton, P. Raguram, D. C. Houghton

Pathology

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background: Neutrophil predominant capillaritis and interstitial inflammation is an uncommon renal biopsy finding, with a broad differential diagnosis. Case: A 77-year-old woman presented with a complicated history including vasculitis, cryoglobulinemia, malaise, and systemic symptoms, which progressed to acute kidney injury. Renal biopsy demonstrated prominent neutrophilic capillaritis with interstitial inflammation, and fibrinoid deposits in medullary capillaries and interstitium. Glomeruli showed membranoproliferative glomerulonephritis, but no crescents or necrosis. Discussion: We interpret the capillary and interstitial changes as evidence of cryoglobulin-associated vasculitis, and discuss the differential diagnosis of this uncommon histologic pattern of renal pathology, including other vasculitides, infection, ischemia-infarction, collagen vascular disease, and antibody-mediated allograft rejection, among others.

Original language	English (US)
Pages (from-to)	159-164
Number of pages	6
Journal	Clinical Nephrology
Volume	76
Issue number	2
DOIs	https://doi.org/10.5414/CN106626
State	Published - Aug 2011

Keywords

ANCA
Cryoglobulin
Necrotizing capillaritis
Vasculitis

ASJC Scopus subject areas

Nephrology

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10.5414/CN106626

Cite this

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title = "Acute kidney injury with cryoglobulinemic peritubular neutrophilic capillaritis",

abstract = "Background: Neutrophil predominant capillaritis and interstitial inflammation is an uncommon renal biopsy finding, with a broad differential diagnosis. Case: A 77-year-old woman presented with a complicated history including vasculitis, cryoglobulinemia, malaise, and systemic symptoms, which progressed to acute kidney injury. Renal biopsy demonstrated prominent neutrophilic capillaritis with interstitial inflammation, and fibrinoid deposits in medullary capillaries and interstitium. Glomeruli showed membranoproliferative glomerulonephritis, but no crescents or necrosis. Discussion: We interpret the capillary and interstitial changes as evidence of cryoglobulin-associated vasculitis, and discuss the differential diagnosis of this uncommon histologic pattern of renal pathology, including other vasculitides, infection, ischemia-infarction, collagen vascular disease, and antibody-mediated allograft rejection, among others.",

keywords = "ANCA, Cryoglobulin, Necrotizing capillaritis, Vasculitis",

author = "Troxell, {M. L.} and Shackleton, {D. V.} and P. Raguram and Houghton, {D. C.}",

year = "2011",

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T1 - Acute kidney injury with cryoglobulinemic peritubular neutrophilic capillaritis

AU - Troxell, M. L.

AU - Shackleton, D. V.

AU - Raguram, P.

AU - Houghton, D. C.

PY - 2011/8

Y1 - 2011/8

N2 - Background: Neutrophil predominant capillaritis and interstitial inflammation is an uncommon renal biopsy finding, with a broad differential diagnosis. Case: A 77-year-old woman presented with a complicated history including vasculitis, cryoglobulinemia, malaise, and systemic symptoms, which progressed to acute kidney injury. Renal biopsy demonstrated prominent neutrophilic capillaritis with interstitial inflammation, and fibrinoid deposits in medullary capillaries and interstitium. Glomeruli showed membranoproliferative glomerulonephritis, but no crescents or necrosis. Discussion: We interpret the capillary and interstitial changes as evidence of cryoglobulin-associated vasculitis, and discuss the differential diagnosis of this uncommon histologic pattern of renal pathology, including other vasculitides, infection, ischemia-infarction, collagen vascular disease, and antibody-mediated allograft rejection, among others.

AB - Background: Neutrophil predominant capillaritis and interstitial inflammation is an uncommon renal biopsy finding, with a broad differential diagnosis. Case: A 77-year-old woman presented with a complicated history including vasculitis, cryoglobulinemia, malaise, and systemic symptoms, which progressed to acute kidney injury. Renal biopsy demonstrated prominent neutrophilic capillaritis with interstitial inflammation, and fibrinoid deposits in medullary capillaries and interstitium. Glomeruli showed membranoproliferative glomerulonephritis, but no crescents or necrosis. Discussion: We interpret the capillary and interstitial changes as evidence of cryoglobulin-associated vasculitis, and discuss the differential diagnosis of this uncommon histologic pattern of renal pathology, including other vasculitides, infection, ischemia-infarction, collagen vascular disease, and antibody-mediated allograft rejection, among others.

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KW - Cryoglobulin

KW - Necrotizing capillaritis

KW - Vasculitis

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Acute kidney injury with cryoglobulinemic peritubular neutrophilic capillaritis

Abstract

Keywords

ASJC Scopus subject areas

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