Glomerular annular-tubular immune deposits in adult hemolytic uremic syndrome.
An 82-year-old female developed hemolytic uremic syndrome (HUS) after a prodromal illness of bloody diarrhea. No specific enteric pathogen was isolated. A renal biopsy performed 5 days after the onset of azotemia revealed typical thrombotic microangiopathy. By electron microscopy, massive annular-tubular deposits admixed with fibrillar fibrin were demonstrated in glomerular capillaries. Immunofluorescent staining of the intracapillary material was positive for IgG, IgM, C3, C1q and fibrin-related antigens. No evidence of plasma cell dyscrasia, cryoglobulinemia or systemic lupus erythematosus was found, and the patient recovered renal function uneventfully in 2 months. Organized immune deposits appear to have played a role in the pathogenesis of HUS in this patient.
Schwartzman
M S
MS
Department of Nephrology, Mary Imogene Bassett Hospital, Cooperstown, N.Y.
D'Agati
V
V
D000368:Aged; D000369:Aged, 80 and over; D003166:Complement Activating Enzymes / Q000032:analysis; D003172:Complement C1 / Q000032:analysis; D015922:Complement C1q; D003176:Complement C3 / Q000032:analysis; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007075:Immunoglobulin M / Q000032:analysis*; D007678:Kidney Glomerulus / Q000276:immunology* / Q000473:pathology; D007684:Kidney Tubules / Q000276:immunology* / Q000473:pathology
D003172:Complement C1; D003176:Complement C3; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D015922:Complement C1q; D003166:Complement Activating Enzymes