Flow chart illustrating the hypothetical pathophysiology of the most striking histomorphologic features shown in electron micrographs of medulla obtained.

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Presentation transcript:

Flow chart illustrating the hypothetical pathophysiology of the most striking histomorphologic features shown in electron micrographs of medulla obtained by kidney biopsy from a patient with severe acute Dobrava hantavirus nephropathy. Flow chart illustrating the hypothetical pathophysiology of the most striking histomorphologic features shown in electron micrographs of medulla obtained by kidney biopsy from a patient with severe acute Dobrava hantavirus nephropathy. Severe congestion (A, arrows) and focal, exaggerated necrotizing (B, *) destructive injury of peritubular capillary (B, arrows) expressing profound changes in permeability with resultant leakage of blood fluid and cells into the interstitium (A and B). Involved cytokines are IL-1, IL-2, IL-6, IL-10, IL-12, TNF-α, INF-γ, and vascular endothelial growth factor (VEGF) and chemokines are RANTES, monocyte chemoattractant protein-1 (MCP-1), IP-10, and IL-8. ICAM-1, intercellular adhesion molecule-1; PECAM-1, platelet-endothelial cell adhesion molecule-1; VCAM, vascular cell adhesion molecule-1. Dušan Ferluga, and Alenka Vizjak JASN 2008;19:1653-1658 ©2008 by American Society of Nephrology