Abstract: FR-PO961
Clinicopathologic Findings in Kidney Biopsies from Patients with Pancreatitis
Session Information
- Pathology and Lab Medicine - 1
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- Kurien, Anila Abraham, Renopath Center for Renal and Urological Pathology Pvt Ltd, Chennai, Tamil Nadu, India
- K.S, Jansi Prema, Renopath Center for Renal and Urological Pathology Pvt Ltd, Chennai, Tamil Nadu, India
- Cv, Malathi, Renopath Center for Renal and Urological Pathology Pvt Ltd, Chennai, Tamil Nadu, India
- Caza, Tiffany, Arkana Laboratories, Little Rock, Arkansas, United States
Background
Patients developing acute kidney injury (AKI) in the setting of pancreatitis rarely undergo kidney biopsy, however, histopathologic findings vary and biopsies can inform proper diagnosis and treatment. We present a series of 62 patients with acute or chronic pancreatitis who underwent kidney biopsy to demonstrate the spectrum of pathologic diagnoses in this setting.
Methods
Patients with a clinical history of pancreatitis were identified from renal pathology archives at the Renopath Center for Renal and Urological Pathology in Chennai, India. Clinical data, laboratory values, and histopathology were reviewed
Results
A total of 62 patients with pancreatitis who underwent a native kidney biopsy were identified. The mean age of patients was 35 ± 13 years. There was male predominance (85.5%). Twelve patients had a history of diabetes (19%) and 28 had hypertension (45%). All patients presented with AKI or rapidly progressive renal failure with a mean creatinine of 2.5 ± 2.3 mg/dL.
Of the 62 patients, 54 had acute pancreatitis (87%) and 8 had chronic calcific pancreatitis (13%). Six patients had recurrent pancreatitis (10%). Fifteen patients had ≥ 1 diagnosis (24.2%). These included 16 separate entities. Diagnoses included, in descending order, thrombotic microangiopathy (TMA, n=21), acute tubular injury (ATI, n=19), ATI with pigmented casts (n=8), diabetic glomerulopathy (n=6), acute interstitial nephritis (n=4), renal cortical necrosis (n=4), chronic tubulointerstitial nephritis (CTIN, n=3), crescentic glomerulonephritis (n=2), proliferative glomerulonephritis (n=2), renal papillary necrosis (n=1), nephrocalcinosis (n=1), minimal change disease (n=1), IgA nephropathy (n=1), arterionephrosclerosis (n=1), collapsing glomerulopathy (n=1), and extramedullary hematopoiesis (n=1).
For patients with TMA, 10 had concurrent cortical necrosis (47.6%). Of patients with ATI with pigmented casts, 3 had myoglobin-positivity (consistent with rhabdomyolysis), and 1 was both myoglobin and hemoglobin positive. Of patients with CTIN, one was IgG4-related disease. Of crescentic glomerulonephritis cases, one was pauci-immune and one was anti-GBM disease
Conclusion
Patients presenting with renal failure in the setting of pancreatitis had a wide array of diagnoses, supporting use of biopsy in management of these critically ill patients.