TY - JOUR
T1 - Renal involvement in AIDS
T2 - Sonographic-pathologic correlation
AU - Hamper, U. M.
AU - Goldblum, L. E.
AU - Hutchins, G. M.
AU - Sheth, S.
AU - Dahnert, W. F.
AU - Bartlett, J. G.
AU - Sanders, R. C.
PY - 1988
Y1 - 1988
N2 - Renal sonography was performed in 36 patients with clinical and/or laboratory evidence of AIDS, usually because of deteriorating renal function. In 15 patients, histopathologic specimens were reviewed to characterize renal pathologic changes underlying the sonographic findings. Sonographic evaluation included determination of renal size and cortical echogenicity according to a standard grading system. Pathologic specimens were evaluated for tubular and glomerular abnormalities. Sonography showed either normal-sized or enlarged kidneys with grade I cortical echogenicity in 13 patients (36%), grade II in three patients (8%), and grade III in five patients (14%). Fifteen patients (42%) had normal renal echogenicity. In addition to focal segmental glomerulosclerosis the pathologic examination showed different degrees of tubular abnormalities. Striking, irregularly dilated, infolded tubules with flattened epithelium and intratubular deposits of proteinaceous material, and sometimes cystlike formation involving the medulla and cortex, were seen in two patients with grade III kidneys, and mild dilatation of the tubules was seen in four patients with grade I disease. Moderate tubular dilatation was observed in one patient with grade I disease. No significant tubular abnormality was seen in one patient with grade I disease or in seven patients with normal renal echogenicity. Although glomerular changes contribute to the increase in renal echogenicity, we postulate that the main factors responsible for the increased echogenicity in AIDS nephropathy are the striking tubular abnormalities seen in these patients.
AB - Renal sonography was performed in 36 patients with clinical and/or laboratory evidence of AIDS, usually because of deteriorating renal function. In 15 patients, histopathologic specimens were reviewed to characterize renal pathologic changes underlying the sonographic findings. Sonographic evaluation included determination of renal size and cortical echogenicity according to a standard grading system. Pathologic specimens were evaluated for tubular and glomerular abnormalities. Sonography showed either normal-sized or enlarged kidneys with grade I cortical echogenicity in 13 patients (36%), grade II in three patients (8%), and grade III in five patients (14%). Fifteen patients (42%) had normal renal echogenicity. In addition to focal segmental glomerulosclerosis the pathologic examination showed different degrees of tubular abnormalities. Striking, irregularly dilated, infolded tubules with flattened epithelium and intratubular deposits of proteinaceous material, and sometimes cystlike formation involving the medulla and cortex, were seen in two patients with grade III kidneys, and mild dilatation of the tubules was seen in four patients with grade I disease. Moderate tubular dilatation was observed in one patient with grade I disease. No significant tubular abnormality was seen in one patient with grade I disease or in seven patients with normal renal echogenicity. Although glomerular changes contribute to the increase in renal echogenicity, we postulate that the main factors responsible for the increased echogenicity in AIDS nephropathy are the striking tubular abnormalities seen in these patients.
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U2 - 10.2214/ajr.150.6.1321
DO - 10.2214/ajr.150.6.1321
M3 - Article
C2 - 3285651
AN - SCOPUS:0023878739
SN - 0361-803X
VL - 150
SP - 1321
EP - 1325
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 6
ER -