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CASE 69 (November 2011)
Clinical information
The patient is a 59 year-old woman who
developed sepsis originating from diverticulitis of the colon. She needed
partial colectomy and several surgeries later because of persistent intraabdominal
infection. He has received several antibiotics, including cephalosporins,
amikacin and colistin. Although there is marked improvement in sepsis
and general conditions, begins to rise gradually creatinine to 5.8 mg/dL,
BUN 98 mg/dL. Personal antecedents: systemic hypertension for 4 years,
controlled with ACE inhibitors.
With the diagnosis of acute renal failure
of unclear cause, a renal biopsy was undertaken. See
the images.

Figure 1.
H&E, X100.

Figure 2.
H&E, X400.

Figure 3.
H&E,
X400.

Figure 4.
H&E, X400.

Figure 5.
H&E, X400.

Figure 6.
PAS,
X400.

Figure 7.
PAS,
X400.

Figure8.
Masson's trichrome stain,
X200.

Figure 9.
Masson's trichrome stain,
X400.
Immunofluorescence staining for IgA,
IgG, IgM, C3, C1q, kappa, and lambda: Negative.
What is your diagnosis?
See
diagnosis and discussion
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