Presentation is loading. Please wait.

Presentation is loading. Please wait.

CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology.

Published byRuth Mozley Modified over 9 years ago

Similar presentations

Presentation on theme: "CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology."— Presentation transcript:

1 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Case -7 Dr. BHAVANA MEHTA Consultant pathologist Supratech micropath laboratory and research institute, Ahmedabad SUPRATECH MICROPATH LABORATORY & RESEARCH INSTITUTE

2 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Clinical details 38 yrs, male Renal transplant-5 yrs back On cyclosporin,Azoran, steroids S cr- gradually increased upto 3.0, urine protein++ Renal biopsy done

3 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 CASE 1

4 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008

5 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008

6 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008

7 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008

8 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Provisional Diagnosis Post transplant myeloma cast nephropathy

9 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Why cast nephropathy in post Tx  Allograft nephropathy  ARF  Drug related cast

10 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Pathogenesis of myeloma cast nephropathy  Common in multiple myeloma  Due to over production and precipitation of light chain  Resistant to degradation due to structural changes  Increased urinary calcium due to hypercalcemia  Acute renal failure due to other disease (volume depletion  Drug related –loop diuretics by increasing luminal NaCl  Radiocontrast media interacting with light chains

11 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 What are myeloma casts? Precipitated light chains in distal and collecting tubules +other filtered proteins+Tamm-Horsfall mucoprotein which a protein normally secreted by cells of thick ascending loop of Henle and constitute matrix of all urinary casts Disruption of BM of tubule-leakage-cellular reaction

12 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Other disease with myeloma casts Acinar cell carcinoma, pancreas Waldenstrom macroglobulinemia B cell lymphomas Thyroid carcinoma

13 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 History retrieved H/o basic disease-Myeloma kidney diagnosed in 2001 Urine-Bence John’s protein present Protein electrophoresis –M band present

14 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Final diagnosis  Relapse of myeloma cast nephropathy, renal graft.  Donor-sister  No family history  Post transplant period-no problem till 5 yrs

15 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Post Tx myeloma cast nephropathy Usually Tx not considered in myeloma pt. Becasuse of risk of recurrence & relapse If in remission for 1 yr, considered for Tx Usually recurrence noted within 2 yrs

16 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Post Tx myeloma cast nephropathy One case reported in early transplant period associated with thrombotic microangiopathy Upto 10 cases of MM and few with AL amyloidosis received Tx- more post Tx mortality With recent treatments available for MM- Better post Transplant period

17 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008 Reasons to present this case Young Patient to have MM No Bone marrow involvement Intraabdominal mass-reported as Multiple myeloma Late graft dysfunction-5 yrs Presently on Thalidomide and doing well patient

18 CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology (ISN) -ISNCON 2008

Download ppt "CME on Renal Pathology, 17th December 08, Pune Indian Society of Renal and Transplantation Pathology in collaboration with Indian Society of Nephrology."

Similar presentations

Myeloma Round Table Beth Faiman MSN, APRN-BC, AOCN Nurse Practitioner, Cleveland Clinic Pre-Doctoral Fellow, Case Western Reserve.

Myeloma Round Table Beth Faiman MSN, APRN-BC, AOCN Nurse Practitioner, Cleveland Clinic Pre-Doctoral Fellow, Case Western Reserve.
PLASMA CELL DYSCRASIAS Monoclonal gammopathy of uncertain significance (MGUS)  Idiopathic  Associated with other diseases (autoimmune, infectious, non-heme.

PLASMA CELL DYSCRASIAS Monoclonal gammopathy of uncertain significance (MGUS)  Idiopathic  Associated with other diseases (autoimmune, infectious, non-heme.
Staff Oncologist, Mayo Clinic Arizona

Staff Oncologist, Mayo Clinic Arizona
Acute Renal Failure Acute Renal Failure Dr. Rawi Ramadan Dept. of Nephrology Rambam Medical Center.

Acute Renal Failure Acute Renal Failure Dr. Rawi Ramadan Dept. of Nephrology Rambam Medical Center.
Role of recurrent disease for late allograft loss Fernando G. Cosio Mayo Clinic, Rochester MN 10 th Banff conference on allograft pathology.

Role of recurrent disease for late allograft loss Fernando G. Cosio Mayo Clinic, Rochester MN 10 th Banff conference on allograft pathology.
POLYOMAVIRUS INFECTION IN RENAL ALLOGRAFTS: PROGRESS SINCE BANFF 1999 Parmjeet Randhawa Associate Professor Division of Transplantation Pathology Department.

POLYOMAVIRUS INFECTION IN RENAL ALLOGRAFTS: PROGRESS SINCE BANFF 1999 Parmjeet Randhawa Associate Professor Division of Transplantation Pathology Department.
Tuesday Case Conference

Tuesday Case Conference
Slide Seminar Drugs and Kidney Case 3 Heinz Regele Department of Pathology.

Slide Seminar Drugs and Kidney Case 3 Heinz Regele Department of Pathology.
Objectives To introduce the terminology used in describing the plasma cells neoplasm. To explain the physiology of the normal cells & the pathological.

Objectives To introduce the terminology used in describing the plasma cells neoplasm. To explain the physiology of the normal cells & the pathological.
Renal biopsy case Niels Marcussen Odense University Hospital Denmark.

Renal biopsy case Niels Marcussen Odense University Hospital Denmark.
This lecture was conducted during the Nephrology Unit Grand Ground by Medical Student rotated under Nephrology Division under the supervision of Prof.

This lecture was conducted during the Nephrology Unit Grand Ground by Medical Student rotated under Nephrology Division under the supervision of Prof.
Control of Renal Function. Learning Objectives Know the effects of aldosterone, angiotensin II and antidiuretic hormone on kidney function. Understand.

Control of Renal Function. Learning Objectives Know the effects of aldosterone, angiotensin II and antidiuretic hormone on kidney function. Understand.
This lecture was conducted during the Nephrology Unit Grand Ground by a Sub- intern under Nephrology Division, Department of Medicine in King Saud University.

This lecture was conducted during the Nephrology Unit Grand Ground by a Sub- intern under Nephrology Division, Department of Medicine in King Saud University.
Waldenstrom’s Macroglobulinemia

Waldenstrom’s Macroglobulinemia
DPT IPMR KMU Dr. Rida Shabbir.  K+ extracellular 4.2 mEq/L  Increase in conc to 3-4 mEq/L causes cardiac arrhythmias causing cardiac arrest and fibrilation.

DPT IPMR KMU Dr. Rida Shabbir.  K+ extracellular 4.2 mEq/L  Increase in conc to 3-4 mEq/L causes cardiac arrhythmias causing cardiac arrest and fibrilation.
O THER MALIGNANT LYMPHOPROLIFERATIVE DISORDERS The lymphomas and plasma cell problems.

O THER MALIGNANT LYMPHOPROLIFERATIVE DISORDERS The lymphomas and plasma cell problems.
Diagnosis and Treatment of Multiple Myeloma Mark B. Juckett MD Division of Hematology University of Wisconsin December 11, 2002.

Diagnosis and Treatment of Multiple Myeloma Mark B. Juckett MD Division of Hematology University of Wisconsin December 11, 2002.
NYU Medical Grand Rounds Clinical Vignette Ankit Parikh MD, PGY-2 January 6, 2009 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.

NYU Medical Grand Rounds Clinical Vignette Ankit Parikh MD, PGY-2 January 6, 2009 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.
Cast Nephropathy & Plasmapheresis Alicia Notkin February 6, 2008.

Cast Nephropathy & Plasmapheresis Alicia Notkin February 6, 2008.
Cancer Among Native Americans in Arizona and New Mexico Data Provided by Arizona Cancer Registry at the Arizona Department of Health Services and the New.

Cancer Among Native Americans in Arizona and New Mexico Data Provided by Arizona Cancer Registry at the Arizona Department of Health Services and the New.

Similar presentations

Ads by Google