CASE 54 (August 2010)
Clinical information
A 33-year-old woman with ESRD of unknown
cause was kidney transplanted from a deceased woman donor who died of
hemorrhagic cerebrovascular disease. The donor had antecedent of systemic
hypertension on medical treatment; she was in intensive care unit 48 hours
before of diagnosis of brain death; the blood pressure was high and difficult
to control; serum creatinine at admission: 1.0 mg/dL; it increased until
1.5 mg/dL after 48 hours in intensive care unit.
After trasnplantation: diuresis 5.6 liters
the firts day, but serum creatine did not decrease; on the 6th day she
continued on dialysis. A renal biopsy was performed (Figures 1-7).
The mate receptor (from de same donor)
also had delayed graft function, continued on dialysis and was graft biopsied
on the 7th day (figures 8-11).
C4d in both biopsies: Negative.
See the microscopic images.
Figure 1.
H&E, X200.
Figure 2.
H&E, X400.
Figure 3.
H&E, X400.
Figure 4. Methenamine-silver
stain, X400.
Figure 5.
Methenamine-silver
stain, X400.
Figure 6.
H&E , X400.
Figure 7.
Masson's
trichrome stain, X400.
Figure 8.
The mate kidney. H&E, X400.
Figure 9.
The mate kidney. Left: H&E, X400.
Right: Methenamine-silver
stain, X400.
Figure 10.
The mate kidney. Left: Masson's
trichrome stain,X400. Right:
Methenamine-silver
stain, X400.
Figure 11.
The mate kidney. Left: H&E,
X400. Right: Masson's trichrome stain,
X400.
Wath is your diagnosis?
See
diagnosis and discussion
[Top]
|