Pathologic Evaluation of Canine Renal Biopsies: Methods for Identifying Features that Differentiate Immune‐Mediated Glomerulonephritides from Other Categories of Glomerular Diseases

Cianciolo, Rachel E.; Brown, Cathy A.; Mohr, Frederick C; Spangler, W. L.; Aresu, Luca; Lugt, Jaco J. Van der; Jansen, J. H.; James, Carolyn R; Clubb, Fred J.; Lees, George E.

doi:10.1111/jvim.12226

Cited by 49 publications

(66 citation statements)

References 9 publications

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“…Biopsy specimens without evident glomerular immune‐complex (IC) deposits were further categorized as amyloidosis, glomerulosclerosis (ie, focal segmental glomerulosclerosis), other non‐IC glomerulopathy, non‐IC nephropathy (ie, diseases of the entire kidney), or primary tubulointerstitial disease. Categorization of cases as ICGN and amyloidosis was consistent with diagnostic criteria developed and used by the World Small Animal Veterinary Association Renal Standardization Study Group …”

Section: Methodsmentioning

confidence: 97%

Prevalence of Immune‐Complex Glomerulonephritides in Dogs Biopsied for Suspected Glomerular Disease: 501 Cases (2007–2012)

Schneider

Cianciolo

Nabity

et al. 2013

Veterinary Internal Medicne

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Background Glomerulonephropathies are common causes of kidney disease in dogs. Objective To determine the prevalence of immune‐complex glomerulonephritis (ICGN) in North American dogs biopsied for suspected glomerular disease. Animals Renal biopsies (n = 733) submitted to the Texas Veterinary Renal Pathology Service between January 1, 2007 and December 31, 2012 were reviewed. Dogs were included if the biopsy was performed for suspected glomerular disease. Methods Specimens were evaluated by light microscopy (LM), immunofluorescence (IF), and transmission electron microscopy (TEM). Findings were retrospectively evaluated to categorize the diagnosis for each case. For the diagnosis of ICGN, TEM findings were considered conclusive when LM and IF were equivocal. Results Of the 501 dogs included in the study, 241 (48.1%) had ICGN; 103 (20.6%) had primary glomerulosclerosis; 76 (15.2%) had amyloidosis; 45 (9.0%) had nonimmune complex (IC) glomerulopathy; 24 (4.8%) had non‐IC nephropathy; and, 12 (2.4%) had primary tubulointerstitial disease. Many (66/241; 27.4%) ICGN cases required TEM for definitive diagnosis, including 14 cases (5.8%) that were not suspected on LM. Of cases not diagnosed as ICGN, a substantial proportion (60/260; 23.1%) required TEM to rule out immune complex deposits, including 14 of 189 cases (7.4%) presumptively diagnosed as ICGN on LM. Conclusions and Clinical Importance Approximately half of all dogs biopsied for suspected glomerular disease had conditions other than ICGN. Renal biopsy is needed to accurately categorize the underlying disease and direct appropriate treatment. Additionally, TEM and IF evaluations by experienced nephropathologists are necessary to obtain an accurate diagnosis in many cases.

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Section: Methodsmentioning

confidence: 97%

Prevalence of Immune‐Complex Glomerulonephritides in Dogs Biopsied for Suspected Glomerular Disease: 501 Cases (2007–2012)

Schneider

Cianciolo

Nabity

et al. 2013

Veterinary Internal Medicne

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“…To our knowledge, ours is the first study to describe biochemical and histopathological evidence of renal injury in dogs with coccidioidomycosis, including glomerular lesions suggestive of ICGN. Immune complex glomerulonephritis is a common form of glomerular disease in dogs, with 1 study finding that approximately half (48%) of all kidney tissue biopsied because of suspected glomerular disease had ICGN . Underlying causes of ICGN in dogs include chronic infections with arthropod‐borne pathogens (especially Ehrlichia canis , Babesia canis , Leishmania spp., and Dirofilaria immitis ), but chronic Coccidioides spp.…”

Section: Discussionmentioning

confidence: 99%

“…When a urinalysis was available, many of those dogs (71%) had proteinuria reported as 3+ or 4+ or at least 500 mg/dL. Biopsy samples from dogs should be evaluated with a combination of light microscopy (LM), transmission electron microscopy (TEM), and immunofluorescence (IF), as is the standard in human medicine . Given the retrospective nature of our study, we were only able to evaluate biopsy samples by LM because tissue was not preserved for other diagnostic methods.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic and Histopathologic Renal Abnormalities in Dogs with Coccidioidomycosis

Mehrkens

Mohr

Sykes

2016

Veterinary Internal Medicne

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BackgroundWe observed evidence of protein‐losing nephropathy in some dogs with coccidioidomycosis, suggestive of immune complex glomerulonephritis (ICGN). The goal of this study was to understand the prevalence of renal histopathologic lesions and proteinuria in dogs with coccidioidomycosis.HypothesisBiochemical and histopathological evidence of glomerular lesions is present in dogs with coccidioidomycosis.AnimalsHundred and fifty‐six dogs with naturally occurring coccidioidomycosis.MethodsRetrospective case series. Clinical information and results of clinicopathologic testing were retrieved from the University of California, Davis Veterinary Medical Teaching Hospital (VMTH). Microscopic sections of renal tissue procured from necropsy of dogs with coccidioidomycosis were examined to evaluate the nature and distribution of lesions.ResultsA total of 156 dogs with coccidioidomycosis were identified; 87 dogs had serum biochemistry and a urinalysis performed, 17 had urine protein:creatinine ratios (UPCs), and 24 had renal tissue available for histopathology. Eleven (13%) of the 87 dogs were azotemic, 55 (63%) were proteinuric (of which 14 [25%] had clinically relevant proteinuria defined as ≥3+ or ≥500 mg/dL), and 14 dogs had UPC ≥0.5 (range, 0.5–21.5, median 4.2). Thirteen (54%) of 24 dogs had renal histopathologic lesions suggestive of ICGN. Seven of these dogs had urinalyses performed; 5 (71%) had clinically relevant proteinuria as described above. Two dogs (33%) with normal glomeruli had granulomatous nephritis, 1 of which had intralesional Coccidioides spherules.Conclusions and Clinical ImportanceCoccidioidomycosis should be considered as a possible contributor to glomerular disease in dogs. Whether similar lesions occur in other mammalian hosts, including humans, warrants further investigation.

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“…The diagnosis of ICGN requires renal biopsy with evaluation by light microscopy (LM), transmission electron microscopy (TEM) and immunofluorescence (IF) (Cianciolo et al . ). Although renal biopsy procedures in dogs (by ultrasound‐guided percutaneous approach, laparotomy or laparoscopy) are considered relatively safe, historically, complications are reported in up to 13% of cases with the most common complication being severe haemorrhage and death in 2.5% of cases (Vaden et al .…”

Section: Introductionmentioning

confidence: 97%

Occurrence, management and outcome of immune‐complex glomerulonephritis in dogs with suspected glomerulopathy in the UK

Vessières¹,

Cianciolo

Kisielewicz

et al. 2019

J of Small Animal Practice

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Objectives To determine the proportion of dogs diagnosed with immune‐complex glomerulonephritis in a large cohort of UK dogs with clinical suspicion of glomerular disease in which renal histopathology, including routine light microscopy, transmission electron microscopy and immunofluorescence, had been performed. The second objective was to describe treatment and long‐term clinical outcome of dogs diagnosed with immune‐complex glomerulonephritis. Materials and Methods Sixty‐two UK dogs that underwent renal biopsies for investigation of suspected glomerulopathy (urine protein‐to‐creatinine ratio persistently >0.5) were included in this retrospective multicentre study. Signalment, clinico‐pathological abnormalities, histopathological diagnosis, treatment following diagnosis and survival were recorded. Results Seventeen (27%) of the dogs with suspected glomerular disease were diagnosed with immune‐complex glomerulonephritis and nine (53%) of these were still alive at the study end point, with a median follow‐up of 366 days (range 52 to 1299). Six dogs diagnosed with immune‐complex glomerulonephritis were treated with mycophenolate. Four received mycophenolate alone for immunosuppression and two received mycophenolate and chlorambucil; all these six dogs were alive at data collection [median follow‐up time 712.5 days (range 73 to 1299)]. Seven dogs diagnosed with immune‐complex glomerulonephritis did not receive immunosuppressive treatment; only one of these dogs was alive at study end point [median survival time 302 days (range 52 to 723)]. Clinical Significance Immune‐complex glomerulonephritis may be less common in the UK than previously reported in North America and mainland Europe, reducing the likelihood of treatment modification following renal biopsy. Mycophenolate was the most commonly used immunosuppressant for cases of immune‐complex glomerulonephritis.

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Pathologic Evaluation of Canine Renal Biopsies: Methods for Identifying Features that Differentiate Immune‐Mediated Glomerulonephritides from Other Categories of Glomerular Diseases

Cited by 49 publications

References 9 publications

Prevalence of Immune‐Complex Glomerulonephritides in Dogs Biopsied for Suspected Glomerular Disease: 501 Cases (2007–2012)

Prevalence of Immune‐Complex Glomerulonephritides in Dogs Biopsied for Suspected Glomerular Disease: 501 Cases (2007–2012)

Clinicopathologic and Histopathologic Renal Abnormalities in Dogs with Coccidioidomycosis

Occurrence, management and outcome of immune‐complex glomerulonephritis in dogs with suspected glomerulopathy in the UK

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