NDLI: Vascular Occlusion in Kidney Biopsy Is Characteristic of Clinically Manifesting Thrombotic Microangiopathy

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Vascular Occlusion in Kidney Biopsy Is Characteristic of Clinically Manifesting Thrombotic Microangiopathy

Content Provider	MDPI
Author	Minna, Seppälä Anne, Räisänen-Sokolowski Kovala, Marja Kaartinen, Kati Meri, Seppo Honkanen, Eero
Copyright Year	2022
Description	Thrombotic microangiopathy (TMA) can sometimes manifest only histologically. Our aim was to retrospectively compare biopsy-proven adult TMA patients showing only histological (h-TMA) or both histological and clinical (c-TMA) TMA in 2006–2017. All native kidney biopsies with TMA were included. Biopsies were re-evaluated by light and electron microscopy, and immunofluorescence. Clinical characteristics, laboratory variables, and treatments were recorded from the electronic medical database. Patients were categorized into h-TMA and c-TMA and these groups were compared. In total, 30 biopsy-proven cases among 7943 kidney biopsies were identified and, of these, 15 had h-TMA and 15 c-TMA. Mean follow-up was 6.3 y, and 73.3% had secondary hemolytic uremic syndrome (HUS) and the rest were atypical HUS. Patient characteristics, treatments, and kidney, and patient survival in the groups were similar. Statistically significant differences were found in histological variables. Vascular myxoid swelling and vascular onion-skinning were almost exclusively detected in c-TMA and, thus, vascular occlusive changes indicate clinically apparent rather than merely histological TMA. In addition, regardless of clinical presentation, kidney and patient survival times were similar in the patient groups highlighting the importance of a kidney biopsy in the case of any kidney-related symptoms.
Starting Page	3124
e-ISSN	20770383
DOI	10.3390/jcm11113124
Journal	Journal of clinical medicine
Issue Number	11
Volume Number	11
Language	English
Publisher	MDPI
Publisher Date	2022-05-31
Access Restriction	Open
Subject Keyword	Journal of clinical medicine Journal of Clinical Medicine Pathology Thrombotic Microangiopathy Histological Tma Clinical Tma Kidney Biopsy Secondary Hus Atypical Hus
Content Type	Text
Resource Type	Article

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