Microvascular inflammation and acute tubular necrosis are major histologic features of hantavirus nephropathy
| Autor: | Laurence Vrigneaud, David Buob, Anderson Ratsimbazafy, Marie-Christine Copin, Viviane Gnemmi, Jérôme Verine, François Glowacki, Anny Dewilde |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Pathology Hantavirus Infections Inflammation Kidney Pathology and Forensic Medicine Internal medicine medicine Humans Acute tubular necrosis Retrospective Studies medicine.diagnostic_test business.industry Acute kidney injury Acute Kidney Injury Kidney Tubular Necrosis Acute Middle Aged medicine.disease medicine.anatomical_structure Microvessels Nephritis Interstitial Immunohistochemistry Female Renal biopsy medicine.symptom Hantavirus Infection business |
| Zdroj: | Human Pathology. 46:827-835 |
| ISSN: | 0046-8177 |
| Popis: | Hantavirus nephropathy (HVN) is an uncommon etiology of acute renal failure due to hantavirus infection. Pathological features suggestive of HVN historically reported are medullary interstitial hemorrhages in a background of acute interstitial nephritis (AIN). However, interstitial hemorrhages may be lacking because of medullary sampling error. This emphasizes that other pathological criteria may be of interest. We performed a retrospective clinicopathological study of 17 serologically proven HVN cases with renal biopsy from 2 nephrology centers in northern France. Histologic analysis was completed by immunohistochemistry with anti-CD3, anti-CD68, and anti-CD34 antibodies. Three control groups were not related to hantavirus infection: acute tubular necrosis (ATN) of ischemic or toxic etiology and AIN were used for comparison. Renal biopsy analysis showed that almost all HVN cases with medullary sampling (9/10) displayed interstitial hemorrhages, whereas focal hemorrhages were detected in 2 of the 7 "cortex-only" specimens. ATN was common, as it was present in 15 (88.2%) of 17 HVN cases. By contrast, interstitial inflammation was scarce with no inflammation or only slight inflammation, representing 15 (88.2%) of 17 cases. Moreover, HVN showed inflammation of renal microvessels with cortical peritubular capillaritis and medullary vasa recta inflammation; peritubular capillaritis was significantly higher in HVN after comparison with ischemic and toxic ATN controls (P = .0001 and P = .003, respectively), but not with AIN controls. Immunohistochemical studies highlighted the involvement of T cells and macrophages in renal microvascular inflammation related to HVN. Our study showed that microvascular inflammation, especially cortical peritubular capillaritis, and ATN are important histologic features of HVN. |
| Databáze: | OpenAIRE |
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