title: Methods of analysis for peritubular capillaritis and glomerulitis in acute renal rejection: capillaritis in management of routine diagnosis.
abstract: Glomerulitis and peritubular capillaritis have been recognized as important lesions in acute renal rejection (AR). We studied glomerulitis and peritubular capillaritis in AR by 2 methods and investigated associations with C4d, type/grade of AR, and allograft survival time. Glomerulitis was measured according to Banff scores (glomerulitis by Banff Method [gBM]) and by counting the number of intraglomerular inflammatory cells (glomerulitis by Quantitative Method [gQM]). Capillaritis was classified by the Banff scoring system (peritubular capillaritis by Banff Method [ptcBM]) and by counting the number of cells in peritubular capillaries in 10 high-power fields (hpf; peritubular capillaritis by Quantitative Method [ptcQM]). These quantitative analyses were performed in an attempt to improve our understanding of the role played by glomerulitis and capillaritis in AR. The g0 + g1 group (gBM) associated with negative C4d (P = .02). In peritubular capillaritis, a larger number of cells per 10 hpf in peritubular capillaries (ptcQM) were observed in positive C4d cases (P = .03). The group g2 + g3 (gBM) correlated with graft loss (P = .01). Peritubular capillaritis was not significantly related to graft survival time. Our study showed that the Banff scoring system is the best method to study glomerulitis and observed that the evaluation of capillaritis in routine biopsies is difficult and additional studies are required for a better understanding of its meaning in AR biopsy specimens of renal allografts.
authors: Department of Pathology, Botucatu School of Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil. Electronic address: danielacristinadossantosd@gmail.com.
authors: D C
authors: DC
authors: Dos Santos
authors: Department of Internal Medicine, Botucatu School of Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
authors: L G M
authors: LG
authors: De Andrade
authors: Department of Internal Medicine, Botucatu School of Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
authors: M F C
authors: MF
authors: De Carvalho
authors: Department of Pathology, Amaral Carvalho Hospital, Jaú, São Paulo, Brazil.
authors: F A
authors: FA
authors: Moraes Neto
authors: Department of Pathology, Botucatu School of Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
authors: R M
authors: RM
authors: Viero
mesh_terms: D000328:Adult; D001706:Biopsy; D002196:Capillaries / Q000473:pathology*; D042783:Endothelial Cells / Q000276:immunology; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000209:etiology*; D006084:Graft Rejection; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology*; D007678:Kidney Glomerulus / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006680:HLA Antigens; D007166:Immunosuppressive Agents