Case #15: H13-6814: Acute tubulo-interstitial nephritis (Sjogren Syndrome)
Introduction
Introduction
39 years old female patient with history of dryness of the mouth and eyes, presented with increased serum creatinine :135µmol/L (normal 53-106). Her urine analysis shows 1+ proteinuria, WBC 3/hpf, RBC 20/hpf. A renal biopsy is performed.
Discussion
Discussion Case 15
Question#1 and 2: Patients with Sjogren syndrome may show renal manifestations depending on the renal component affected : glomerular, tubulo-interstitial or vascular. In this patient, the interstitium shows infiltration by lymphocytes and plasma as has been described typically in patients with Sjogren syndrome. The lymphocytes and plasma cells are also noted in the minor salivary glands among other sites , and the biopsy of the oral mucosa is a major diagnostic procedure to support the diagnosis of Sjogren syndrome.
Question #2: The GMS stain is known as one of the two stains of choice for fungal organisms, the other is the PASD stain. The septae of the hyphae react with the silver component of the GMS stain to give the characteristic black color noted in the photomicrograph.