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metadata.dc.type: | Artigo de Periódico |
Title: | Occurrence of Urinary Tract Infection in Patients with Renal Allograft Biopsies Showing Neutrophilic Tubulitis |
Other Titles: | Modern Pathology |
Authors: | Fonseca Jr., Luciano Espinheira Shapiro, Ron Randhawa, Parmjeet S. |
metadata.dc.creator: | Fonseca Jr., Luciano Espinheira Shapiro, Ron Randhawa, Parmjeet S. |
Abstract: | Lymphocytic tubulitis is a well-accepted criterion for acute cellular rejection in renal allograft biopsies. Neutrophilic tubulitis has been used as a surrogate marker for urinary tract infection, but it is not clear how reliably this lesion can be used to make this diagnosis. Biopsy findings were correlated with clinical features in 26 renal allograft biopsies with interstitial polymorphonuclear infiltrates associated with neutrophilic tubulitis. The grade of neutrophilic tubulitis exceeded the grade of lymphocytic tubulitis in 7 (44%) of 16 patients with, but in only 0 patients without, a positive urine culture. Culture confirmed urinary tract infection in 16 (62%) of 26 patients. It is possible that prior antibiotic therapy led to a false-negative culture and masked the diagnosis in two additional patients. Lymphocytic tubulitis made it difficult to exclude concurrent acute cellular rejection in all biopsies studied. In 6 (23%) of 26 patients, negative cultures and response to steroid treatment confirmed that neutrophilic tubulitis can occur in biopsies without urinary tract infection. The relative contributions of infection and rejection could not be determined in patients treated with both steroids and antibiotics. Neutrophilic tubulitis in a renal allograft biopsy should alert the clinician to the possibility of urinary tract infection, even if concurrent lymphocytic tubulitis is present. Confirmation by urine culture is needed because biopsies with ischemic injury and acute cellular or antibody-mediated rejection can show overlapping histology. |
Keywords: | Allograft Kidney Renal Transplantation Urinary tract infection |
metadata.dc.rights: | Acesso Aberto |
URI: | http://repositorio.ufba.br/ri/handle/ri/14315 |
Issue Date: | 2003 |
Appears in Collections: | Artigo Publicado em Periódico (Faculdade de Medicina) |
Files in This Item:
File | Description | Size | Format | |
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Luciano Espinheira Fonseca Jr..pdf | 1,13 MB | Adobe PDF | View/Open |
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