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Cholemic Nephrosis: An Autopsy Study of a Forgotten Entity
Cholemic Nephrosis: An Autopsy Study of a Forgotten Entity
- Source :
- Türk Patoloji Dergisi, Vol 37, Iss 3, Pp 212-218 (2021)
- Publication Year :
- 2021
- Publisher :
- Federation of Turkish Pathology Societies, 2021.
-
Abstract
- Objective: The aim of the study is to do a clinicopathologic study of post mortem kidney biopsies with significant deposition of bilirubin pigment within tubular epithelial cells and in the lumen of distal tubules as a bile cast. Material and Method: All post mortem specimens with acute tubular necrosis, with the presence of bile casts in tubules or bile pigment deposition in the tubular epithelium during the period 2015-2018 were examined for gross and histopathology along with biochemical parameters and viral markers. Results: Bile casts with sloughed renal tubular epithelial cells and occasional macrophages were present in the distal convoluted tubule in 78.6% of biopsies (11/14). The plugging of distal convoluted tubule with casts was similar to that seen in myeloma and myoglobin cast nephropathies. Bilirubin pigment deposition was present in 35.7% (5/14) of cases. The frequency of bile casts in each biopsy was variable and it did not have any association with serum bilirubin levels or etiology of liver dysfunction. A striking difference from earlier studies is the high number of toxin-induced liver damage including six cases of paraquat and 2 cases of yellow phosphorus poisoning. Conclusion: This study proves importance of the bile cast nephropathy as a reason for kidney injury, especially with varied hepatotoxic etiologies, especially paraquat and yellow phosphorus.
- Subjects :
- bile
toxin
nephropathy
Pathology
RB1-214
Subjects
Details
- Language :
- English
- ISSN :
- 10185615 and 13095730
- Volume :
- 37
- Issue :
- 3
- Database :
- Directory of Open Access Journals
- Journal :
- Türk Patoloji Dergisi
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.2d3a1600b5d34bb0b786f106076a919b
- Document Type :
- article
- Full Text :
- https://doi.org/10.5146/tjpath.2021.01532