Myeloid bodies in the renal tubules of humans: Relationship to gentamicin therapy

Ultrastructural changes in renal proximal tubule lysosomes, including the formation of myeloid bodies occur reliably with gentamicin administration in experimental animals. The present study reviewed the electron microscopic tubular morphology of renal biopsies and nephrectomies performed in our institution over a 2-year period. The frequency of myeloid bodies and their relation to drug therapy and selected clinical features were determined. Myeloid bodies were found in the proximal tubules of 19 of 109 cases that were judged adequate for study. On review of the drug histories of these 19 patients, 15 had received gentamicin within 6 weeks of biopsy or nephrectomy. None of the 90 patients without myeloid bodies had received the drug within 6 weeks of tissue examination. Of 4 patients with myeloid bodies who had not received gentamicin, 1 had received chloroquin and 3 had received drugs with no known or suspected capacity to induce myeloid bodies. The presence of myeloid bodies in proximal tubules did not appear to be related to the total dose of gentamicin, duration of therapy, or serum drug concentration. Clinical evidence of gentamicin nephrotoxicity was present in only 1 case.