Lysozyme-Induced Nephropathy

doi:10.1016/j.ekir.2016.09.002

Case Reports

. 2016 Sep 9;2(1):84-88.

doi: 10.1016/j.ekir.2016.09.002. eCollection 2017 Jan.

Lysozyme-Induced Nephropathy

Dominick Santoriello¹, Laurie May Andal², Robert Cox³, Vivette D D'Agati¹, Glen S Markowitz¹

Affiliations

¹ Department of Pathology & Cell Biology, Columbia University Medical Center, New York, New York, USA.
² Department of Medicine, Division of Nephrology, Christiana Care Health System, Newark, Delaware, USA.
³ Department of Medicine, Division of Nephrology, VA Medical Center, Wilmington, Delaware, USA.

PMID: 29142945
PMCID: PMC5678613
DOI: 10.1016/j.ekir.2016.09.002

Case Reports

Lysozyme-Induced Nephropathy

Dominick Santoriello et al. Kidney Int Rep. 2016.

. 2016 Sep 9;2(1):84-88.

doi: 10.1016/j.ekir.2016.09.002. eCollection 2017 Jan.

Authors

Dominick Santoriello¹, Laurie May Andal², Robert Cox³, Vivette D D'Agati¹, Glen S Markowitz¹

Affiliations

¹ Department of Pathology & Cell Biology, Columbia University Medical Center, New York, New York, USA.
² Department of Medicine, Division of Nephrology, Christiana Care Health System, Newark, Delaware, USA.
³ Department of Medicine, Division of Nephrology, VA Medical Center, Wilmington, Delaware, USA.

PMID: 29142945
PMCID: PMC5678613
DOI: 10.1016/j.ekir.2016.09.002

No abstract available

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Figures

**Figure 1**
A low-power view demonstrates widespread proximal tubular degenerative changes and interstitial edema. (a) A glomerulus appears unremarkable (hematoxylin and eosin, original magnification ×200). (b) At higher magnification, many proximal tubular cells are distended by numerous small intracytoplasmic PAS+ granules (arrow; periodic acid–Schiff, original magnification ×400). (c) Immunohistochemial staining for lysozyme shows intense granular reactivity in the distribution of proximal tubular cell cytoplasm (immunoperoxidase, original magnification ×100). (d) No significant staining is seen in a paired negative control obtained from an allograft postreperfusion biopsy (immunoperoxidase, original magnification ×100). (e) On ultrastructural evaluation, proximal tubular cells contain abundant membrane-bound vacuoles (arrow; original magnification ×8000). (f) On closer inspection, the vacuoles in proximal tubules contain clumped, degenerating organellar debris, consistent with autophagolysosomes (arrow; original magnification ×25,000). (g) In rare cells, the autophagolysomes appear to form larger, membrane-bound aggregates (arrow; original magnification ×6,000), corresponding to the (h) scattered large round eosinophilic inclusions seen in a minority of cells (arrow; hematoxylin and eosin, original magnification ×600).

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References

1. Salahudeen A.K., Doshi S.M., Pawar T. Incidence rate, clinical correlates, and outcomes of AKI in patients admitted to a comprehensive cancer center. Clin J Am Soc Nephrol. 2013;8:347–354. - PMC - PubMed
1. Christiansen C.F., Johansen M.B., Langeberg W.J. Incidence of acute kidney injury in cancer patients: a Danish population-based cohort study. Euro J Intern Med. 2011;22:399–406. - PubMed
1. Ganguli A., Sawinski D., Berns J.S. Kidney diseases associated with haematological cancers. Nat Rev Nephrol. 2015;1:478–490. - PubMed
1. Canet E., Zafrani L., Lambert J. Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival. PLoS One. 2013;8:e55870. - PMC - PubMed
1. Luciano R.L., Brewster U.C. Kidney involvement in leukemia and lymphoma. Adv Chronic Kidney Dis. 2014;21:27–35. - PubMed

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[1] Salahudeen A.K., Doshi S.M., Pawar T. Incidence rate, clinical correlates, and outcomes of AKI in patients admitted to a comprehensive cancer center. Clin J Am Soc Nephrol. 2013;8:347–354. - PMC - PubMed

[2] Salahudeen A.K., Doshi S.M., Pawar T. Incidence rate, clinical correlates, and outcomes of AKI in patients admitted to a comprehensive cancer center. Clin J Am Soc Nephrol. 2013;8:347–354. - PMC - PubMed

[3] Christiansen C.F., Johansen M.B., Langeberg W.J. Incidence of acute kidney injury in cancer patients: a Danish population-based cohort study. Euro J Intern Med. 2011;22:399–406. - PubMed

[4] Christiansen C.F., Johansen M.B., Langeberg W.J. Incidence of acute kidney injury in cancer patients: a Danish population-based cohort study. Euro J Intern Med. 2011;22:399–406. - PubMed

[5] Ganguli A., Sawinski D., Berns J.S. Kidney diseases associated with haematological cancers. Nat Rev Nephrol. 2015;1:478–490. - PubMed

[6] Ganguli A., Sawinski D., Berns J.S. Kidney diseases associated with haematological cancers. Nat Rev Nephrol. 2015;1:478–490. - PubMed

[7] Canet E., Zafrani L., Lambert J. Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival. PLoS One. 2013;8:e55870. - PMC - PubMed

[8] Canet E., Zafrani L., Lambert J. Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival. PLoS One. 2013;8:e55870. - PMC - PubMed

[9] Luciano R.L., Brewster U.C. Kidney involvement in leukemia and lymphoma. Adv Chronic Kidney Dis. 2014;21:27–35. - PubMed

[10] Luciano R.L., Brewster U.C. Kidney involvement in leukemia and lymphoma. Adv Chronic Kidney Dis. 2014;21:27–35. - PubMed

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Lysozyme-Induced Nephropathy

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