Microvascular inflammation and acute tubular necrosis are major histologic features of hantavirus nephropathy

Human Pathology
Viviane GnemmiDavid Buob

Abstract

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. Moreov...Continue Reading

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Citations

Jan 23, 2016·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Lu-Xi ZouLing Sun
Jan 5, 2017·Infectious Diseases·Jukka MustonenSatu Mäkelä
Jun 12, 2019·Viruses·Miriam MaasBarry Rockx
Jan 26, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Juliet SchurderAlexandre Hertig
Jun 1, 2018·Nephron Extra·Markus MeierMartin Nitschke

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