Isolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient
Abstract Background Acute kidney injury is a frequent cause of hospital readmission in kidney transplant recipients (KTR), usually associated with infections and graft rejection. Herein, we report a case of an unusual cause of acute kidney injury in a KTR (massive histiocytes renal interstitial infi...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-023-03135-z |
| _version_ | 1797853968068509696 |
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| author | Luis E. M. Martins Miguel Moyses-Neto Roberto S. Costa Fabiola Traina Elen A. Romao |
| author_facet | Luis E. M. Martins Miguel Moyses-Neto Roberto S. Costa Fabiola Traina Elen A. Romao |
| author_sort | Luis E. M. Martins |
| collection | DOAJ |
| description | Abstract Background Acute kidney injury is a frequent cause of hospital readmission in kidney transplant recipients (KTR), usually associated with infections and graft rejection. Herein, we report a case of an unusual cause of acute kidney injury in a KTR (massive histiocytes renal interstitial infiltration). Case presentation A 40-year-old woman was submitted to a second kidney transplant. One year after surgery, she presented asthenia, myalgia, and fever, haemoglobin 6.1 g/dL; neutrophils: 1.3 × 109/µL; platelets: 143 × 109/µL; blood creatinine 11.8 mg/dL, requiring dialysis. A kidney biopsy revealed diffuse histiocytic infiltration, which was assumed due to dysregulated immunological activation triggered by infections. The patient had multiple infections, including cytomegalovirus infection (CMV), aspergillosis, bacteraemia, and urinary tract infections, which could trigger the immune response. Haemophagocytic lymphohistiocytosis (HLH) was ruled out. The present case highlights the occurrence of isolated massive renal interstitial infiltration of histiocytes that does not meet the criteria for HLH or other related pathologies. Conclusions Renal histiocyte activation and infiltration may have been initiated by an immunological mechanism similar to what occurs in HLH and infectious processes. The present case highlights the occurrence of isolated massive renal interstitial infiltration of histiocytes that does not meet the criteria for HLH or other related pathologies. |
| first_indexed | 2024-04-09T19:59:20Z |
| format | Article |
| id | doaj.art-1d15bbde405e46d399474b6d3503ee1c |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-09T19:59:20Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-1d15bbde405e46d399474b6d3503ee1c2023-04-03T05:19:45ZengBMCBMC Nephrology1471-23692023-03-012411410.1186/s12882-023-03135-zIsolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipientLuis E. M. Martins0Miguel Moyses-Neto1Roberto S. Costa2Fabiola Traina3Elen A. Romao4Division of Nephrology, Ribeirao Preto Medical School, University of Sao PauloDivision of Nephrology, Ribeirao Preto Medical School, University of Sao PauloDivision of Nephrology, Ribeirao Preto Medical School, University of Sao PauloDepartment of Medical Imaging, Hematology, and Clinical Oncology, Ribeirao Preto Medical School, University of Sao PauloDivision of Nephrology, Ribeirao Preto Medical School, University of Sao PauloAbstract Background Acute kidney injury is a frequent cause of hospital readmission in kidney transplant recipients (KTR), usually associated with infections and graft rejection. Herein, we report a case of an unusual cause of acute kidney injury in a KTR (massive histiocytes renal interstitial infiltration). Case presentation A 40-year-old woman was submitted to a second kidney transplant. One year after surgery, she presented asthenia, myalgia, and fever, haemoglobin 6.1 g/dL; neutrophils: 1.3 × 109/µL; platelets: 143 × 109/µL; blood creatinine 11.8 mg/dL, requiring dialysis. A kidney biopsy revealed diffuse histiocytic infiltration, which was assumed due to dysregulated immunological activation triggered by infections. The patient had multiple infections, including cytomegalovirus infection (CMV), aspergillosis, bacteraemia, and urinary tract infections, which could trigger the immune response. Haemophagocytic lymphohistiocytosis (HLH) was ruled out. The present case highlights the occurrence of isolated massive renal interstitial infiltration of histiocytes that does not meet the criteria for HLH or other related pathologies. Conclusions Renal histiocyte activation and infiltration may have been initiated by an immunological mechanism similar to what occurs in HLH and infectious processes. The present case highlights the occurrence of isolated massive renal interstitial infiltration of histiocytes that does not meet the criteria for HLH or other related pathologies.https://doi.org/10.1186/s12882-023-03135-zAcute kidney injuryGraft lossHistiocytes renal interstitial infiltrationKidney transplantationRenal biopsyCase report |
| spellingShingle | Luis E. M. Martins Miguel Moyses-Neto Roberto S. Costa Fabiola Traina Elen A. Romao Isolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient BMC Nephrology Acute kidney injury Graft loss Histiocytes renal interstitial infiltration Kidney transplantation Renal biopsy Case report |
| title | Isolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient |
| title_full | Isolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient |
| title_fullStr | Isolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient |
| title_full_unstemmed | Isolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient |
| title_short | Isolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient |
| title_sort | isolated massive histiocytes renal interstitial infiltration a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient |
| topic | Acute kidney injury Graft loss Histiocytes renal interstitial infiltration Kidney transplantation Renal biopsy Case report |
| url | https://doi.org/10.1186/s12882-023-03135-z |
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