Myoglobin casts in renal biopsies: immunohistochemistry and morphologic spectrum

Liapis, Helen; Boils, Christie L.; Hennigar, Randolph A.; Silva, Fred

doi:10.1016/j.humpath.2016.02.026

Cited by 22 publications

(18 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 In addition, myoglobin casts may be absent in kidney biopsy specimens from patients with rhabdomyolysis. 19 In this study, only five donors had typical myoglobin casts in the kidneys on pathological evaluation.…”

Section: Discussionmentioning

confidence: 90%

Kidney transplantation from donors with rhabdomyolysis and acute renal failure

Chen

Zheng

Zhou

et al. 2017

Clinical Transplantation

View full text Add to dashboard Cite

Rhabdomyolysis in deceased donors usually causes acute renal failure (ARF), which may be considered a contraindication for kidney transplantation. From January 2012 to December 2016, 30 kidneys from 15 deceased donors with severe rhabdomyolysis and ARF were accepted for transplantation at our center. The peak serum creatinine (SCr) kinase, myoglobin, and SCr of the these donors were 15 569±8597 U/L, 37 092±42 100 μg/L, and 422±167 μmol/L, respectively. Two donors received continuous renal replacement therapy due to anuria. Six kidneys exhibited a discolored appearance (from brown to glossy black) due to myoglobin casts. The kidney transplant results from the donors with rhabdomyolysis donors were compared with those of 90 renal grafts from standard criteria donors (SCD). The estimated glomerular filtration rate at 2 years was similar between kidney transplants from donors with rhabdomyolysis and SCD (70.3±14.6 mL/min/1.73 m vs 72.3±15.1 mL/min/1.73 m ). We conclude that excellent graft function can be achieved from kidneys donors with ARF caused by rhabdomyolysis.

show abstract

Section: Discussionmentioning

confidence: 90%

Kidney transplantation from donors with rhabdomyolysis and acute renal failure

Chen

Zheng

Zhou

et al. 2017

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…While the 1‐h OHTx recipients demonstrated elevated serum chemistries compared with baseline controls, their levels decreased by POD 3. The end‐organ damage seen on histology of kidney samples is in a pattern consistent with rhabdomyolysis . Despite identical surgical approaches aside from cold ischemia time, the 6‐h OHTx recipients were unable to recover from the local tissue damage.…”

Section: Discussionmentioning

confidence: 98%

Prolonged Cold Ischemia Time Results in Local and Remote Organ Dysfunction in a Murine Model of Vascularized Composite Transplantation

Datta

Devaney

Busuttil

et al. 2017

American Journal of Transplantation

View full text Add to dashboard Cite

Vascularized composite allotransplantation (VCA) is a viable reconstructive option for complex tissue defects. Although grafts with a large muscular component may be uniquely susceptible to ischemia-reperfusion (I/R) syndrome, the safe cold ischemia time in VCA has not been established. We investigated the effects of cold ischemia on innate immune response and recipient survival in a murine orthotopic hindlimb transplantation model. Surprisingly, mice receiving grafts exposed to 6 h or longer of cold storage demonstrated reduced survival and massive elevations in serum creatinine, blood urea nitrogen, and creatine kinase, compared with 1 h of cold storage recipients. This was accompanied by progressive increase in macrophage and neutrophil cell infiltration in muscle biopsy specimens, altered platelet endothelial cell adhesion molecule-1 expression, and ultimate renal injury. Multiplex immunoassay analysis identified 21 cytokines in serum and 18 cytokines in muscle biopsy specimens that are likely essential in the complex response to I/R-triggered injury in VCA. In conclusion, this study, in a mouse model of orthotopic hindlimb transplantation, is the first to document that prolonged cold ischemia triggers progressive I/R injury with vascular endothelial damage and may lead to irrecoverable local and remote organ damage. These experimental findings are important in guiding future therapies for human VCA recipients.

show abstract

“…This is followed by muscle diseases, trauma, seizures, immobility and metabolic causes. [ 1 2 ] The major causes of rhabdomyolysis in India include snake envenomation, wasp sting, strenuous exercise and seizures. [ 3 ] We sought to retrospectively analyse the clinicopathological characteristics of myoglobin cast nephropathy in a large series of renal biopsies.…”

Section: Introductionmentioning

confidence: 99%

Etiological Spectrum and Histopathological Diagnosis of Rhabdomyolysis Associated Myoglobin Cast Nephropathy in South India

Prema¹,

Kurien²

2021

Indian J Nephrol

View full text Add to dashboard Cite

Background and Aims: Rhabdomyolysis occurs due to injury to skeletal muscle fibers and the release of muscle constituents into the circulation. Myoglobin cast nephropathy leading to acute kidney injury is one of the most severe complications of rhabdomyolysis. This is a retrospective study which aims to analyse the clinicopathological features of myoglobin cast nephropathy. Methods: A total of 57 cases of myoglobin cast nephropathy were identified after performing immunohistochemical staining for myoglobin on all renal biopsies with pigment casts. The clinical, laboratory data, histopathological findings and clinical outcome of these cases were evaluated. Results: The mean patient age was 34.47 years (range 17-77) and the male to female ratio was 6.1:1. All patients presented with acute kidney injury with mean serum creatinine of 8.4 mg/dl (range: 1.7 to 20.8 mg/dl). Rhabdomyolysis was clinically suspected only in 31 patients. Along with myoglobin casts, acute tubular injury was present in all the biopsies. The most frequent conditions associated with myoglobin cast nephropathy in our study were snake envenomation and unaccustomed physical activities. A few activities that caused rhabdomyolysis in our patients were unique to India. Conclusion: Clinicians should be aware of the wide spectrum of causes for rhabdomyolysis. The classical clinical and laboratory findings of rhabdomyolysis may not be present in many of the patients. The pathologist must have a high index of suspicion, and immunohistochemical stain should be used to confirm the diagnosis.

show abstract

Myoglobin casts in renal biopsies: immunohistochemistry and morphologic spectrum

Cited by 22 publications

References 23 publications

Kidney transplantation from donors with rhabdomyolysis and acute renal failure

Kidney transplantation from donors with rhabdomyolysis and acute renal failure

Prolonged Cold Ischemia Time Results in Local and Remote Organ Dysfunction in a Murine Model of Vascularized Composite Transplantation

Etiological Spectrum and Histopathological Diagnosis of Rhabdomyolysis Associated Myoglobin Cast Nephropathy in South India

Contact Info

Product

Resources

About