Del Sordo R, Covarelli C, Brugnano R, Sciri R, Bellezza G, Mandarano M, Sidoni A. PLA2R Immunohistochemistry Staining in Membranous Glomerulopathy: A Challenging Stain to Interpret But a Potentially Useful Diagnostic Tool. Appl Immunohistochem Mol Morphol. 2021 Epub ahead of print. [PubMed link]
Detection of PLA2R antigen in renal tissue, with immunohistochemistry (PLA2R IHC), strongly correlates with serum PLA2R-Ab, although in literature has no univocal interpretation.
Akilesh S, Nast CC, Yamashita M, Henriksen K, Charu V, Troxell ML, Kambham N, Bracamonte E, Houghton D, Ahmed NI, Chong CC, Thajudeen B, Rehman S, Khoury F, Zuckerman JE, Gitomer J, Raguram PC, Mujeeb S, Schwarze U, Shannon MB, De Castro I, Alpers CE, Najafian B, Nicosia RF, Andeen NK, Smith KD. Multicenter Clinicopathologic Correlation of Kidney Biopsies Performed in COVID-19 Patients Presenting With Acute Kidney Injury or Proteinuria. Am J Kidney Dis. 2021 Jan;77(1):82-93.e1. [PubMed link]
A case series of 17 patients with SARS-CoV-2 infection confirmed by reverse transcriptase-polymerase chain reaction, only 3 presented with severe COVID-19 symptoms. Acute kidney injury (n=15) and proteinuria (n=11) were the most common indications for biopsy and these symptoms developed concurrently or within 1 week of COVID-19 symptoms in all patients. Acute tubular injury (n=14), collapsing glomerulopathy (n=7), and endothelial injury/thrombotic microangiopathy (n=6) were the most common histologic findings. 2 of 3 transplant recipients developed active antibody-mediated rejection weeks after COVID-19.
Angelotti ML, Antonelli G, Conte C, Romagnani P. Imaging the kidney: from light to super-resolution microscopy. Nephrol Dial Transplant. 2021 Jan 1;36(1):19-28. [PubMed link]
This review provides an overview of available kidney imaging strategies, with a focus on the possible impact of the most recent technical improvements.
Kudose S, Santoriello D, Debiec H, Canetta PA, Bomback AS, Stokes MB, Batal I, Ronco P, D'Agati VD, Markowitz GS. The clinicopathologic spectrum of segmental membranous glomerulopathy. Kidney Int. 2021 Jan;99(1):247-255. [PubMed link]
Loupy A, Haas M, Roufosse C, et al. The Banff 2019 Kidney Meeting Report (I): Updates on and clarification of criteria for T cell- and antibody-mediated rejection. Am J Transplant. 2020;20(9):2318-2331. [PubMed link]
Segmental membranous glomerulopathy (MGN) is a glomerulonephritis with only segmental immune deposits. It is a rare PLA2R-negative variant of MGN with favorable prognosis, even in the absence of immunosuppressive treatment.
Yu GZ, Guo L, Dong JF, et al. Persistent Hematuria and Kidney Disease Progression in IgA Nephropathy: A Cohort Study. Am J Kidney Dis. 2020;76(1):90-99. [PubMed link]
"Hematuria remission was associated with improved kidney outcomes in IgAN among patients with persistent proteinuria".
Su H, Yang M, Wan C, et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int. 2020;98(1):219-227. [PubMed link]
Diffuse proximal tubule injury with the loss of brush border, non-isometric vacuolar degeneration, and even frank necrosis was observed. Occasional hemosiderin granules and pigmented casts were identified. There were prominent erythrocyte aggregates obstructing the lumen of capillaries without platelet or fibrinoid material. Electron microscopic examination showed clusters of coronavirus-like particles with distinctive spikes in the tubular epithelium and podocytes. Furthermore, the receptor of SARS-CoV-2, ACE2 was found to be upregulated in patients with COVID-19, and immunostaining with SARS-CoV nucleoprotein antibody was positive in tubules.
Miller SE, Brealey JK. Visualization of putative coronavirus in kidney. Kidney Int. 2020;98(1):231-232. [PubMed link]
In this letter, the authors discuss two previous papers (including the previous article) describing "viral particles" evidenced by EM in kidney, and they consider that them are not viral particles, instead subcellular organelles. A very interesting article on viral ultrastructural morphology.
Calomeni E, Satoskar A, Ayoub I, Brodsky S, Rovin BH, Nadasdy T. Multivesicular bodies mimicking SARS-CoV-2 in patients without COVID-19. Kidney Int. 2020;98(1):233-234. [PubMed link]
"Most of the published images depicting the suspected virus are very similar, if not identical, to multivesicular bodies (MVBs). MVBs have been well-known since the 1960s, however, their exact significance and function is unclear.
Coppo R, D'Arrigo G, Tripepi G, et al. Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update. Nephrol Dial Transplant. 2020;35(6):1002-1009. [PubMed link]
M1, S1 and T1-T2 lesions as well as the whole MEST score were independently related with the combined endpoint, and there was no effect modification by age for these associations. Only T lesions were associated with the rate of eGFR loss in the whole cohort, whereas C showed this association only in patients not treated with immunosuppression.
Ahn W, Bomback AS. Approach to Diagnosis and Management of Primary Glomerular Diseases Due to Podocytopathies in Adults: Core Curriculum 2020. Am J Kidney Dis. 2020;75(6):955-964. [PubMed link]
Using case examples, the authors show how alternative classification schemes can assist not only diagnosis, but also long-term management of podocytopathies.