Karyomegalic interstitial nephritis in a renal allograft

Aishwarya Ravindran, Cherise Cortese, Chris P. Larsen, Hani M. Wadei, Manish J. Gandhi, Fernando G Cosio, Sanjeev M Sethi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Karyomegalic interstitial nephritis (KIN) is a rare renal interstitial disease entity characterized by large tubular nuclei, accompanied by interstitial inflammation, tubular atrophy, and interstitial fibrosis. Approximately 50 cases of KIN have been described in the native kidney. In this case study, we describe the first case of KIN in a kidney allograft. A 41-year-old man presented with declining kidney function and a serum creatinine of 2.7 mg/dL. The native kidney biopsy showed large pleomorphic nuclei in the proximal and distal tubular epithelial cells, which was associated with interstitial inflammation, and extensive interstitial fibrosis and tubular atrophy. Immunohistochemistry for cytomegalovirus, adenovirus, and simian virus 40 were negative. A diagnosis of KIN was rendered. The patient received a living-related kidney transplant from his sister. At 4-, 12-, and 24-months posttransplant, protocol allograft biopsies showed KIN with large pleomorphic nuclei in the proximal and distal tubules with mild interstitial inflammation, minimal tubular atrophy, and interstitial fibrosis. At 24.7 months of follow-up, the patient has stable renal function with a serum creatinine of 1.6 mg/dL. The KIN may represent recurrent KIN or donor-associated KIN. Recognition of this rare disease entity is important as it can be mistaken for a viral infection.

Original languageEnglish (US)
JournalAmerican Journal of Transplantation
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Interstitial Nephritis
Allografts
Kidney
Atrophy
Fibrosis
Inflammation
Creatinine
Biopsy
Simian virus 40
Virus Diseases
Rare Diseases
Serum
Cytomegalovirus
Adenoviridae
Siblings
Epithelial Cells
Immunohistochemistry
Tissue Donors
Transplants

Keywords

  • clinical research/practice
  • interstitial fibrosis and tubular atrophy
  • kidney transplantation/nephrology
  • pathology/histopathology
  • recurrent disease

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Ravindran, A., Cortese, C., Larsen, C. P., Wadei, H. M., Gandhi, M. J., Cosio, F. G., & Sethi, S. M. (Accepted/In press). Karyomegalic interstitial nephritis in a renal allograft. American Journal of Transplantation. https://doi.org/10.1111/ajt.15035

Karyomegalic interstitial nephritis in a renal allograft. / Ravindran, Aishwarya; Cortese, Cherise; Larsen, Chris P.; Wadei, Hani M.; Gandhi, Manish J.; Cosio, Fernando G; Sethi, Sanjeev M.

In: American Journal of Transplantation, 01.01.2018.

Research output: Contribution to journalArticle

Ravindran A, Cortese C, Larsen CP, Wadei HM, Gandhi MJ, Cosio FG et al. Karyomegalic interstitial nephritis in a renal allograft. American Journal of Transplantation. 2018 Jan 1. https://doi.org/10.1111/ajt.15035
Ravindran, Aishwarya ; Cortese, Cherise ; Larsen, Chris P. ; Wadei, Hani M. ; Gandhi, Manish J. ; Cosio, Fernando G ; Sethi, Sanjeev M. / Karyomegalic interstitial nephritis in a renal allograft. In: American Journal of Transplantation. 2018.
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