Renal Manifestations of Inflammatory Bowel Disease

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Renal Manifestations of Inflammatory Bowel Disease Josephine M. Ambruzs, MD, MPH, Christopher P. Larsen, MD Rheumatic Disease Clinics Volume 44, Issue 4, Pages 699-714 (November 2018) DOI: 10.1016/j.rdc.2018.06.007 Copyright © 2018 The Author(s) Terms and Conditions

Fig. 1 Glomerular lesions associated with inflammatory bowel disease. (A) Glomerulus with mesangial matrix expansion and hypercellularity in a patient with IgAN and CD (periodic acid–Schiff; original magnification ×400). (B) Positive IgA staining of the glomerular mesangium by immunofluorescence (fluorescein conjugated antihuman IgA; original magnification ×400). (C) Glomerular and vascular amyloid deposits show positive staining for AA in this case of AA amyloidosis and CD (immunoperoxidase; original magnification ×200). (D) Transmission electron photomicrograph showing a glomerulus with numerous subepithelial electron dense deposits (arrows) from a case of membranous glomerulopathy and CD (original magnification ×2000). Tissue staining for the phospholipase A2 receptor (PLA2R) and thrombospondin (THSD7A) were both negative (not shown here). Rheumatic Disease Clinics 2018 44, 699-714DOI: (10.1016/j.rdc.2018.06.007) Copyright © 2018 The Author(s) Terms and Conditions

Fig. 2 Tubulointerstitial lesions associated with IBD. (A) Tubular profiles show simplification, reactive nuclei, and apical cytoplasmic blebbing in this case of acute tubular injury (hematoxylin-eosin; original magnification ×200). (B) Interstitial edema with an intense mixed inflammatory infiltrate and prominent tubulitis diagnostic of acute TIN in a patient with UC (hematoxylin-eosin; original magnification ×100). (C) Intense interstitial inflammation, including epithelioid histiocytes and multinucleated giant cells forming noncaseating granulomata (arrows) from a case of granulomatous TIN in a patient with CD (periodic acid–Schiff; original magnification ×200). (D) The renal interstitium is expanded by fibrosis and has an associated inflammatory infiltrate with severe tubular atrophy in this case of chronic TIN in a patient with UC (Masson trichrome; original magnification ×100). Rheumatic Disease Clinics 2018 44, 699-714DOI: (10.1016/j.rdc.2018.06.007) Copyright © 2018 The Author(s) Terms and Conditions