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Renal interstitial necrotizing granulomas

MedGen UID:
1717627
•Concept ID:
C5397659
•
Pathologic Function
Synonym: Renal interstitial necrotizing granulomata
 
HPO: HP:0032642

Definition

An organized collection of histiocytes (specifically macrophages) localized in the interstitial tissue of the kidney. Through light microscopy, the activated histiocytes appear as epithelioid cells with round to oval nuclei, often with irregular contours and abundant granular eosinophilic cytoplasm with indistinct cell borders. They may also coalesce to form multinucleated giant cells. Granulomas may be associated with a peripheral cuff of lymphoplasmacytic and occasionally eosinophilic inflammation. Organization can range from poorly-to-well defined. Granulomas can present as necrotizing or non-necrotizing. Microscopically, necrotizing granulomas distinctly have central necrosis with a palisaded lymphohistiocytic reaction and a cuff of chronic inflammation. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVRenal interstitial necrotizing granulomas

Professional guidelines

PubMed

Renal sarcoidosis: approach to diagnosis and management.
Bergner R, Löffler C
Curr Opin Pulm Med 2018 Sep;24(5):513-520. doi: 10.1097/MCP.0000000000000504. PMID: 29965860

Recent clinical studies

Etiology

Patterns of lung diseases predict survival in patients with MPO-ANCA-associated vasculitis: a single-center retrospective study.
Yang S, Chai D, Li Y, Wang Y, Zhan X, Zhang L, Wang J, Ye Q
Clin Rheumatol 2022 Mar;41(3):783-793. Epub 2021 Nov 27 doi: 10.1007/s10067-021-05964-5. PMID: 34839416
Renal involvement in eosinophilic granulomatosis with polyangiitis (EGPA): a multicentric retrospective study of 63 biopsy-proven cases.
Durel CA, Sinico RA, Teixeira V, Jayne D, Belenfant X, Marchand-Adam S, Pugnet G, Gaultier J, Le Gallou T, Titeca-Beauport D, Agard C, Barbet C, Bardy A, Blockmans D, Boffa JJ, Bouet J, Cottin V, Crabol Y, Deligny C, Essig M, Godmer P, Guilpain P, Hirschi-Santelmo S, Rafat C, Puéchal X, Taillé C, Karras A; French Vasculitis Study Group (FVSG)
Rheumatology (Oxford) 2021 Jan 5;60(1):359-365. doi: 10.1093/rheumatology/keaa416. PMID: 32856066
Renal sarcoidosis: approach to diagnosis and management.
Bergner R, Löffler C
Curr Opin Pulm Med 2018 Sep;24(5):513-520. doi: 10.1097/MCP.0000000000000504. PMID: 29965860
Pauci-immune glomerulonephritis: does negativity of anti-neutrophilic cytoplasmic antibodies matters?
Sharma A, Nada R, Naidu GS, Minz RW, Kohli HS, Sakhuja V, Gupta KL, Rathi M
Int J Rheum Dis 2016 Jan;19(1):74-81. Epub 2015 Aug 13 doi: 10.1111/1756-185X.12729. PMID: 26269223
Renal involvement in Churg-Strauss syndrome.
Sinico RA, Di Toma L, Maggiore U, Tosoni C, Bottero P, Sabadini E, Giammarresi G, Tumiati B, Gregorini G, Pesci A, Monti S, Balestrieri G, Garini G, Vecchio F, Buzio C
Am J Kidney Dis 2006 May;47(5):770-9. doi: 10.1053/j.ajkd.2006.01.026. PMID: 16632015

Diagnosis

Systemic sarcoidosis presenting as a rare combination of interstitial nephritis with necrotizing vasculitis and urinary retention due to prostate involvement: a case report.
Osanami A, Yamashita T, Sakurada S, Sato T, Kyoda Y, Shindo T, Fujita H, Ogawa Y, Furuhashi M
BMC Nephrol 2023 Dec 13;24(1):370. doi: 10.1186/s12882-023-03430-9. PMID: 38093211Free PMC Article
Patterns of lung diseases predict survival in patients with MPO-ANCA-associated vasculitis: a single-center retrospective study.
Yang S, Chai D, Li Y, Wang Y, Zhan X, Zhang L, Wang J, Ye Q
Clin Rheumatol 2022 Mar;41(3):783-793. Epub 2021 Nov 27 doi: 10.1007/s10067-021-05964-5. PMID: 34839416
Renal sarcoidosis: approach to diagnosis and management.
Bergner R, Löffler C
Curr Opin Pulm Med 2018 Sep;24(5):513-520. doi: 10.1097/MCP.0000000000000504. PMID: 29965860
Pauci-immune glomerulonephritis: does negativity of anti-neutrophilic cytoplasmic antibodies matters?
Sharma A, Nada R, Naidu GS, Minz RW, Kohli HS, Sakhuja V, Gupta KL, Rathi M
Int J Rheum Dis 2016 Jan;19(1):74-81. Epub 2015 Aug 13 doi: 10.1111/1756-185X.12729. PMID: 26269223
Histoplasmosis with hypercalcemia, renal failure, and papillary necrosis. Confusion with sarcoidosis.
Walker JV, Baran D, Yakub N, Freeman RB
JAMA 1977 Mar 28;237(13):1350-2. PMID: 576482

Therapy

Sarcoid-Like Reaction in the Kidney Following Rituximab for Mantle Lymphoma in a 60-Year-Old Man.
Mrabet S, Dahmene R, Fradi A, Jaziri A, Boukadida R, Azzebi A, Sahtout W, Ben Aicha N, Zellama D, Achour A, Abdessayed N, Mokni M
Am J Mens Health 2023 Mar-Apr;17(2):15579883231159343. doi: 10.1177/15579883231159343. PMID: 36864684Free PMC Article
Renal sarcoidosis: approach to diagnosis and management.
Bergner R, Löffler C
Curr Opin Pulm Med 2018 Sep;24(5):513-520. doi: 10.1097/MCP.0000000000000504. PMID: 29965860
Acute kidney injury with granulomatous interstitial nephritis and vasculitis revealing sarcoidosis.
Harzallah A, Kaaroud H, Boubaker K, Barbouch S, Goucha R, Hamida FB, Abdallah TB
Saudi J Kidney Dis Transpl 2017 Sep-Oct;28(5):1157-1161. doi: 10.4103/1319-2442.215120. PMID: 28937078
Long-term outcomes in antineutrophil cytoplasmic autoantibody-positive eosinophilic granulomatosis with polyangiitis patients with renal involvement: a retrospective study of 14 Chinese patients.
Chen Y, Ding Y, Liu Z, Zhang H, Liu Z, Hu W
BMC Nephrol 2016 Jul 26;17(1):101. doi: 10.1186/s12882-016-0319-2. PMID: 27461086Free PMC Article
Pauci-immune glomerulonephritis: does negativity of anti-neutrophilic cytoplasmic antibodies matters?
Sharma A, Nada R, Naidu GS, Minz RW, Kohli HS, Sakhuja V, Gupta KL, Rathi M
Int J Rheum Dis 2016 Jan;19(1):74-81. Epub 2015 Aug 13 doi: 10.1111/1756-185X.12729. PMID: 26269223

Prognosis

Tubulointerstitial Nephritis and Uveitis Syndrome: A Report of 6 Cases with Renal Biopsy and Electron Microscopy Evaluation.
Palamaris K, Stylianou K, Destouni M, Stofas A, Theodoropoulou H, Kroustalakis N, Dermitzaki EK, Petrakis I, Pleros C, Theochari I, Sarantis P, Paliouras C, Gakiopoulou H
Nephron 2024;148(4):204-214. Epub 2023 Aug 23 doi: 10.1159/000533402. PMID: 37611557
Systemic sarcoidosis presenting as a rare combination of interstitial nephritis with necrotizing vasculitis and urinary retention due to prostate involvement: a case report.
Osanami A, Yamashita T, Sakurada S, Sato T, Kyoda Y, Shindo T, Fujita H, Ogawa Y, Furuhashi M
BMC Nephrol 2023 Dec 13;24(1):370. doi: 10.1186/s12882-023-03430-9. PMID: 38093211Free PMC Article
Patterns of lung diseases predict survival in patients with MPO-ANCA-associated vasculitis: a single-center retrospective study.
Yang S, Chai D, Li Y, Wang Y, Zhan X, Zhang L, Wang J, Ye Q
Clin Rheumatol 2022 Mar;41(3):783-793. Epub 2021 Nov 27 doi: 10.1007/s10067-021-05964-5. PMID: 34839416
Pauci-immune glomerulonephritis: does negativity of anti-neutrophilic cytoplasmic antibodies matters?
Sharma A, Nada R, Naidu GS, Minz RW, Kohli HS, Sakhuja V, Gupta KL, Rathi M
Int J Rheum Dis 2016 Jan;19(1):74-81. Epub 2015 Aug 13 doi: 10.1111/1756-185X.12729. PMID: 26269223
Renal involvement in Churg-Strauss syndrome.
Sinico RA, Di Toma L, Maggiore U, Tosoni C, Bottero P, Sabadini E, Giammarresi G, Tumiati B, Gregorini G, Pesci A, Monti S, Balestrieri G, Garini G, Vecchio F, Buzio C
Am J Kidney Dis 2006 May;47(5):770-9. doi: 10.1053/j.ajkd.2006.01.026. PMID: 16632015

Clinical prediction guides

Tubulointerstitial Nephritis and Uveitis Syndrome: A Report of 6 Cases with Renal Biopsy and Electron Microscopy Evaluation.
Palamaris K, Stylianou K, Destouni M, Stofas A, Theodoropoulou H, Kroustalakis N, Dermitzaki EK, Petrakis I, Pleros C, Theochari I, Sarantis P, Paliouras C, Gakiopoulou H
Nephron 2024;148(4):204-214. Epub 2023 Aug 23 doi: 10.1159/000533402. PMID: 37611557
Patterns of lung diseases predict survival in patients with MPO-ANCA-associated vasculitis: a single-center retrospective study.
Yang S, Chai D, Li Y, Wang Y, Zhan X, Zhang L, Wang J, Ye Q
Clin Rheumatol 2022 Mar;41(3):783-793. Epub 2021 Nov 27 doi: 10.1007/s10067-021-05964-5. PMID: 34839416
Renal involvement in eosinophilic granulomatosis with polyangiitis (EGPA): a multicentric retrospective study of 63 biopsy-proven cases.
Durel CA, Sinico RA, Teixeira V, Jayne D, Belenfant X, Marchand-Adam S, Pugnet G, Gaultier J, Le Gallou T, Titeca-Beauport D, Agard C, Barbet C, Bardy A, Blockmans D, Boffa JJ, Bouet J, Cottin V, Crabol Y, Deligny C, Essig M, Godmer P, Guilpain P, Hirschi-Santelmo S, Rafat C, Puéchal X, Taillé C, Karras A; French Vasculitis Study Group (FVSG)
Rheumatology (Oxford) 2021 Jan 5;60(1):359-365. doi: 10.1093/rheumatology/keaa416. PMID: 32856066
Pauci-immune glomerulonephritis: does negativity of anti-neutrophilic cytoplasmic antibodies matters?
Sharma A, Nada R, Naidu GS, Minz RW, Kohli HS, Sakhuja V, Gupta KL, Rathi M
Int J Rheum Dis 2016 Jan;19(1):74-81. Epub 2015 Aug 13 doi: 10.1111/1756-185X.12729. PMID: 26269223
Histologic and immunohistologic study and clinical presentation of ANCA-associated glomerulonephritis with correlation to ANCA antigen specificity.
Vizjak A, Rott T, Koselj-Kajtna M, Rozman B, Kaplan-Pavlovcic S, Ferluga D
Am J Kidney Dis 2003 Mar;41(3):539-49. doi: 10.1053/ajkd.2003.50142. PMID: 12612976

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