The Experts below are selected from a list of 420 Experts worldwide ranked by ideXlab platform
Roger W Byard - One of the best experts on this subject based on the ideXlab platform.
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Hyperosmolarity Induces Armanni-Ebstein-like Renal Tubular Epithelial Swelling and Cytoplasmic Vacuolization.
Journal of Forensic Sciences, 2016Co-Authors: Chong Zhou, Robert Vink, Roger W ByardAbstract:Armanni-Ebstein lesions have been considered pathognomonic for diabetes mellitus and appear as markedly swollen renal tubular epithelial cells with cytoplasmic clearing and glycogen accumulation. However, the extent to which hyperosmolarity contributes to the Armanni-Ebstein phenotype is unclear. Ten sheep were injected intravenously with 20% mannitol at 11 mOsm/kg, and subsequent histological evaluation of the kidneys showed variable degrees of Osmotic Nephrosis and cytoplasmic clearing of renal tubular epithelial cells similar to that seen with Armanni-Ebstein lesions. However, although morphological changes similar to Armanni-Ebstein lesions could be produced, no intracytoplasmic glycogen was demonstrated with periodic Acid-Schiff (PAS) stain. This suggests that while hyperosmolarity may contribute to the development of an Armanni-Ebstein phenotype, glycogen accumulation may result from the more complex metabolic effects of glucose on renal tubular epithelial cells. Thus, when Armanni/Ebstein-like vacuolizations are seen at autopsy, a confirmatory PAS stain is recommended because of the potential effect of hyperosmolar states.
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renal cortical pallor a useful macroscopic marker for metabolic derangements at autopsy
Journal of Forensic Sciences, 2013Co-Authors: Chong Zhou, Andrea J Yool, Roger W ByardAbstract:: Renal cortical pallor was studied as a potential marker at autopsy of diabetic ketoacidosis in 23 cases, hyperglycemic nonketotic coma in eight cases, and alcoholic ketoacidosis in five cases (vitreous humor glucose level≥11.1 mM; β-hydroxybutyrate level≥5 mM). Renal cortical pallor was noted on macroscopic examination in 10 of 23 cases of lethal diabetic ketoacidosis (43.5%), three of eight cases of fatal hyperglycemic nonketotic coma (37.5%), and in two of five cases of alcoholic ketoacidosis (40%). Histologic examination revealed basal vacuolization of renal tubular epithelial cells in 12 cases, Armanni-Ebstein lesions in 10, and Osmotic Nephrosis in three. Although renal cortical pallor did not appear to be a particularly sensitive marker for hyperglycemia or ketoacidosis, and did not correlate with the severity of these parameters, it may still represent a useful macroscopic marker for underlying metabolic conditions at autopsy and should therefore prompt measurement of vitreous humor glucose and β-hydroxybutyrate levels.
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renal cortical pallor a useful macroscopic marker for metabolic derangements at autopsy
Journal of Forensic Sciences, 2013Co-Authors: Chong Zhou, Andrea J Yool, Roger W ByardAbstract:: Renal cortical pallor was studied as a potential marker at autopsy of diabetic ketoacidosis in 23 cases, hyperglycemic nonketotic coma in eight cases, and alcoholic ketoacidosis in five cases (vitreous humor glucose level≥11.1 mM; β-hydroxybutyrate level≥5 mM). Renal cortical pallor was noted on macroscopic examination in 10 of 23 cases of lethal diabetic ketoacidosis (43.5%), three of eight cases of fatal hyperglycemic nonketotic coma (37.5%), and in two of five cases of alcoholic ketoacidosis (40%). Histologic examination revealed basal vacuolization of renal tubular epithelial cells in 12 cases, Armanni-Ebstein lesions in 10, and Osmotic Nephrosis in three. Although renal cortical pallor did not appear to be a particularly sensitive marker for hyperglycemia or ketoacidosis, and did not correlate with the severity of these parameters, it may still represent a useful macroscopic marker for underlying metabolic conditions at autopsy and should therefore prompt measurement of vitreous humor glucose and β-hydroxybutyrate levels.
Chong Zhou - One of the best experts on this subject based on the ideXlab platform.
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Hyperosmolarity Induces Armanni-Ebstein-like Renal Tubular Epithelial Swelling and Cytoplasmic Vacuolization.
Journal of Forensic Sciences, 2016Co-Authors: Chong Zhou, Robert Vink, Roger W ByardAbstract:Armanni-Ebstein lesions have been considered pathognomonic for diabetes mellitus and appear as markedly swollen renal tubular epithelial cells with cytoplasmic clearing and glycogen accumulation. However, the extent to which hyperosmolarity contributes to the Armanni-Ebstein phenotype is unclear. Ten sheep were injected intravenously with 20% mannitol at 11 mOsm/kg, and subsequent histological evaluation of the kidneys showed variable degrees of Osmotic Nephrosis and cytoplasmic clearing of renal tubular epithelial cells similar to that seen with Armanni-Ebstein lesions. However, although morphological changes similar to Armanni-Ebstein lesions could be produced, no intracytoplasmic glycogen was demonstrated with periodic Acid-Schiff (PAS) stain. This suggests that while hyperosmolarity may contribute to the development of an Armanni-Ebstein phenotype, glycogen accumulation may result from the more complex metabolic effects of glucose on renal tubular epithelial cells. Thus, when Armanni/Ebstein-like vacuolizations are seen at autopsy, a confirmatory PAS stain is recommended because of the potential effect of hyperosmolar states.
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renal cortical pallor a useful macroscopic marker for metabolic derangements at autopsy
Journal of Forensic Sciences, 2013Co-Authors: Chong Zhou, Andrea J Yool, Roger W ByardAbstract:: Renal cortical pallor was studied as a potential marker at autopsy of diabetic ketoacidosis in 23 cases, hyperglycemic nonketotic coma in eight cases, and alcoholic ketoacidosis in five cases (vitreous humor glucose level≥11.1 mM; β-hydroxybutyrate level≥5 mM). Renal cortical pallor was noted on macroscopic examination in 10 of 23 cases of lethal diabetic ketoacidosis (43.5%), three of eight cases of fatal hyperglycemic nonketotic coma (37.5%), and in two of five cases of alcoholic ketoacidosis (40%). Histologic examination revealed basal vacuolization of renal tubular epithelial cells in 12 cases, Armanni-Ebstein lesions in 10, and Osmotic Nephrosis in three. Although renal cortical pallor did not appear to be a particularly sensitive marker for hyperglycemia or ketoacidosis, and did not correlate with the severity of these parameters, it may still represent a useful macroscopic marker for underlying metabolic conditions at autopsy and should therefore prompt measurement of vitreous humor glucose and β-hydroxybutyrate levels.
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renal cortical pallor a useful macroscopic marker for metabolic derangements at autopsy
Journal of Forensic Sciences, 2013Co-Authors: Chong Zhou, Andrea J Yool, Roger W ByardAbstract:: Renal cortical pallor was studied as a potential marker at autopsy of diabetic ketoacidosis in 23 cases, hyperglycemic nonketotic coma in eight cases, and alcoholic ketoacidosis in five cases (vitreous humor glucose level≥11.1 mM; β-hydroxybutyrate level≥5 mM). Renal cortical pallor was noted on macroscopic examination in 10 of 23 cases of lethal diabetic ketoacidosis (43.5%), three of eight cases of fatal hyperglycemic nonketotic coma (37.5%), and in two of five cases of alcoholic ketoacidosis (40%). Histologic examination revealed basal vacuolization of renal tubular epithelial cells in 12 cases, Armanni-Ebstein lesions in 10, and Osmotic Nephrosis in three. Although renal cortical pallor did not appear to be a particularly sensitive marker for hyperglycemia or ketoacidosis, and did not correlate with the severity of these parameters, it may still represent a useful macroscopic marker for underlying metabolic conditions at autopsy and should therefore prompt measurement of vitreous humor glucose and β-hydroxybutyrate levels.
Laurent Brochard - One of the best experts on this subject based on the ideXlab platform.
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Colloid-induced kidney injury: experimental evidence may help to understand mechanisms
Critical Care, 2009Co-Authors: Frédérique Schortgen, Laurent BrochardAbstract:Fluid resuscitation is widely used, and many patients are therefore exposed to plasma volume expanders. Among these, colloids, particularly hydroxyethyl starches, have been shown in recent experiments and clinical studies to induce acute kidney injury. The mechanisms of colloid-induced acute kidney injury remain incompletely elucidated. The risks associated with colloid Osmotic pressure elevation in vivo and the high incidence of Osmotic Nephrosis lesions in experimental models and clinical studies indicate that hydroxyethyl starches can no longer be considered safe.
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Commentary Colloid-induced kidney injury: experimental evidence may help to understand mechanisms
2009Co-Authors: Frédérique Schortgen, Laurent BrochardAbstract:Fluid resuscitation is widely used, and many patients are therefore exposed to plasma volume expanders. Among these, colloids, particularly hydroxyethyl starches, have been shown in recent experiments and clinical studies to induce acute kidney injury. The mechanisms of colloid-induced acute kidney injury remain incompletely elucidated. The risks associated with colloid Osmotic pressure elevation in vivo and the high incidence of Osmotic Nephrosis lesions in experimental models and clinical studies indicate that hydroxyethyl starches can no longer be considered safe.
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Commentary Colloid-induced kidney injury: experimental evidence may help to understand
2009Co-Authors: Frédérique Schortgen, Laurent BrochardAbstract:Fluid resuscitation is widely used, and many patients are therefore exposed to plasma volume expanders. Among these, colloids, particularly hydroxyethyl starches, have been shown in recent experiments and clinical studies to induce acute kidney injury. The mechanisms of colloid-induced acute kidney injury remain incompletely elucidated. The risks associated with colloid Osmotic pressure elevation in vivo and the high incidence of Osmotic Nephrosis lesions in experimental models and clinical studies indicate that hydroxyethyl starches can no longer be considered safe. Plasma volume expansion is often required in the operating room, emergency department, or intensive care unit. The safety of plasma volume expanders therefore deserves careful consideration. Low renal perfusion is a major risk factor fo
Sanjeev Sethi - One of the best experts on this subject based on the ideXlab platform.
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triamterene crystalline nephropathy
American Journal of Kidney Diseases, 2014Co-Authors: Samih H Nasr, Dawn S Milliner, Thomas D Wooldridge, Sanjeev SethiAbstract:Medications can cause a tubulointerstitial insult leading to acute kidney injury through multiple mechanisms. Acute tubular injury, a dose-dependent process, occurs due to direct toxicity on tubular cells. Acute interstitial nephritis characterized by interstitial inflammation and tubulitis develops from drugs that incite an allergic reaction. Other less common mechanisms include Osmotic Nephrosis and crystalline nephropathy. The latter complication is rare but has been associated with several drugs, such as sulfadiazine, indinavir, methotrexate, and ciprofloxacin. Triamterene crystalline nephropathy has been reported only rarely, and its histologic characteristics are not well characterized. We report 2 cases of triamterene crystalline nephropathy, one of which initially was misdiagnosed as 2,8-dihydroxyadenine crystalline nephropathy.
Vincent Vuiblet - One of the best experts on this subject based on the ideXlab platform.
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Raman-based detection of hydroxyethyl starch in kidney allograft biopsies as a potential marker of allograft quality in kidney transplant recipients
Scientific Reports, 2016Co-Authors: Vincent Vuiblet, Philippe Birembaut, Olivier Piot, Michael Fere, Ezechiel Bankole, Alain Wynckel, Cyril Gobinet, Philippe RieuAbstract:In brain-dead donor resuscitation, hydroxyethyl starch (HES) use has been associated with presence of Osmotic-Nephrosis-like lesions in kidney transplant recipients. Our aim was to determine whether the presence of HES in protocol renal graft biopsies at three months (M3) after transplantation is associated with renal graft quality. According to the HES administered to the donor during the procurement procedure, two groups of patients were defined according graft exposition to HES: HES group, (N = 20) and control group (N = 6). Detection and relative quantification of HES was performed by Raman spectroscopy microimaging on M3 protocol renal graft biopsies. Statistical analyses were used to investigate the association between Raman data and graft characteristics. HES spectral signal was revealed negative in the control group, whereas it was positive in 40% of biopsies from the HES group. In the HES group, a stronger HES signal was associated with a lower risk of graft failure measured by the Kidney Donor Risk Index (KDRI) and was correlated with the allograft kidney function. Thus, HES accumulation in donor kidney, as probed by Raman biophotonic technique, is correlated with the quality of donor kidney and consequently the graft renal function and graft survival.
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Contribution of Raman spectroscopy in nephrology: a candidate technique to detect hydroxyethyl starch of third generation in Osmotic renal lesions
The Analyst, 2015Co-Authors: Vincent Vuiblet, T. T. Nguyen, A. Wynckel, M. Féré, L. Van-gulick, Valérie Untereiner, Philippe Birembaut, Philippe Rieu, Olivier PiotAbstract:Background and objectives: HydroxyEthyl Starch (HES) has been one of the most commonly used colloid volume expanders in intensive care units for over 50 years. The first and second generation HES, with a high molecular weight (≥200 kD) and a high degree of substitution (≥0.5), has been associated with both renal dysfunction and Osmotic Nephrosis-like lesions in histological studies. Recently, third generation HES (130 kD/
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Crystalline light chain proximal tubulopathy with chronic renal failure and silicone gel breast implants: 1 case report
Human Pathology, 2015Co-Authors: Marie-lucile Figueres, Vincent Vuiblet, Julie Beaume, Marion Rabant, Nader Bassilios, M. Herody, Guy Touchard, Laure-hélène NoëlAbstract:A 39-year-old female patient was admitted to explore chronic renal failure. Clinical history included silicone breast implants. Clinical examination was normal. Urinalysis revealed tubular proteinuria with Bence-Jones κ protein. Monoclonal immunoglobulin G κ and free monoclonal κ-light chains (LCs) were revealed by serum protein immunoelectrophoresis. Bone marrow aspiration with karyotype analysis and skeletal radiologic survey were normal. Kidney biopsy revealed a peculiar pattern of proximal tubular cells with hypertrophy and clarification initially diagnosed as an Osmotic Nephrosis. Immunofluorescence study, including immunoglobulin LCs conjugates was normal. Immunoelectron microscopy finally revealed a crystalline LC proximal tubulopathy κ. Our case presents some peculiarities: the absence of hematologic malignancy sign and the young patient's age. The silicone breast implants have been reported to be involved in the generation of monoclonal gammopathy.
