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Difference between revisions of "Medical kidney diseases"
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→Acute tubular necrosis: more
(→Acute tubular necrosis: more) |
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*Often abbreviated ''ATN''. | *Often abbreviated ''ATN''. | ||
===General=== | ===General=== | ||
* | Diagnosed clinically: | ||
*Using urine R&M - hemegranular casts are diagnostic. | |||
*Anuria or low urine output. | |||
===Gross=== | |||
*Poorly defined corticomedullary junction - soft finding. | |||
*Slightly heavier ~ 180 grams.<ref name=pmid19207286/> | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref> | Features:<ref name=pmid19207286>{{Cite journal | last1 = Kocovski | first1 = L. | last2 = Duflou | first2 = J. | title = Can renal acute tubular necrosis be differentiated from autolysis at autopsy? | journal = J Forensic Sci | volume = 54 | issue = 2 | pages = 439-42 | month = Mar | year = 2009 | doi = 10.1111/j.1556-4029.2008.00956.x | PMID = 19207286 }}</ref> | ||
* | *Tubular epithelial whorls - present in approx. one third of cases - '''most important'''. | ||
* | **Detached epithelium within the luminal space surrounded by epithelium. | ||
** | ***Similar to ''epithelial telescoping'' seen in endometrial biopsies. | ||
*Tubulorrhexis - present in approx. one third of cases. | |||
**Disruption of the tubular basement membrane. | |||
*Interstitial edema - sensitive... but not specific. | |||
Notes - not particularily useful findings: | |||
*Mitoses. | |||
*Casts in tubules. | |||
===IHC=== | ===IHC=== | ||
*Ki-67 - focal nuclear staining of the tubular epithelium. | *Ki-67 - focal nuclear staining of the tubular epithelium.<ref name=pmid19207286/> | ||
==Hepatorenal syndrome== | ==Hepatorenal syndrome== | ||