Methotrexate Crystals on Electron Microscopy of Kidney Biopsy for Acute Kidney Injury
Acute kidney injury secondary to methotrexate therapy for hematologic malignancies is relatively uncommon. Methotrexate crystals in these cases are rarely seen on kidney biopsy, and in particular, their appearance in tissue prepared for transmission electron microscopy has not been described. A male...
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Elsevier
2024-12-01
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| Series: | Kidney Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590059524001353 |
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| author | Diana Fang, MD Noah Poznanski, MD Lois J. Arend, MD, PhD |
| author_facet | Diana Fang, MD Noah Poznanski, MD Lois J. Arend, MD, PhD |
| author_sort | Diana Fang, MD |
| collection | DOAJ |
| description | Acute kidney injury secondary to methotrexate therapy for hematologic malignancies is relatively uncommon. Methotrexate crystals in these cases are rarely seen on kidney biopsy, and in particular, their appearance in tissue prepared for transmission electron microscopy has not been described. A male patient with recurrent primary central nervous system lymphoma received high-dose methotrexate and rituximab for treatment. On day 2 of cycle 3, one day after the infusion of high-dose methotrexate, the patient was found to have high levels of serum methotrexate. Shortly after, he developed acute kidney injury. A kidney biopsy was performed, which showed methotrexate crystals only on tissue submitted for electron microscopy. To our knowledge, this is the first report to characterize methotrexate crystals on toluidine blue-stained thick sections and their ultrastructure on transmission electron microscopy. |
| format | Article |
| id | doaj-art-109aee14f5c24609b50e6f5a06e8f9b4 |
| institution | Kabale University |
| issn | 2590-0595 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney Medicine |
| spelling | doaj-art-109aee14f5c24609b50e6f5a06e8f9b42024-11-18T04:33:32ZengElsevierKidney Medicine2590-05952024-12-01612100924Methotrexate Crystals on Electron Microscopy of Kidney Biopsy for Acute Kidney InjuryDiana Fang, MD0Noah Poznanski, MD1Lois J. Arend, MD, PhD2Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MDDivision of Nephrology, Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MDDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology and Clinical Laboratories, University of Michigan, Ann Arbor, MI; Address for Correspondence: Lois J. Arend, MD, PhD, Department of Pathology and Clinical Laboratories, University of Michigan, 2800 Plymouth Rd, Building 35, Ann Arbor, MI 48109-2800.Acute kidney injury secondary to methotrexate therapy for hematologic malignancies is relatively uncommon. Methotrexate crystals in these cases are rarely seen on kidney biopsy, and in particular, their appearance in tissue prepared for transmission electron microscopy has not been described. A male patient with recurrent primary central nervous system lymphoma received high-dose methotrexate and rituximab for treatment. On day 2 of cycle 3, one day after the infusion of high-dose methotrexate, the patient was found to have high levels of serum methotrexate. Shortly after, he developed acute kidney injury. A kidney biopsy was performed, which showed methotrexate crystals only on tissue submitted for electron microscopy. To our knowledge, this is the first report to characterize methotrexate crystals on toluidine blue-stained thick sections and their ultrastructure on transmission electron microscopy.http://www.sciencedirect.com/science/article/pii/S2590059524001353Methotrexateacute renal failurekidney biopsyultrastructureelectron microscopynephropathology |
| spellingShingle | Diana Fang, MD Noah Poznanski, MD Lois J. Arend, MD, PhD Methotrexate Crystals on Electron Microscopy of Kidney Biopsy for Acute Kidney Injury Kidney Medicine Methotrexate acute renal failure kidney biopsy ultrastructure electron microscopy nephropathology |
| title | Methotrexate Crystals on Electron Microscopy of Kidney Biopsy for Acute Kidney Injury |
| title_full | Methotrexate Crystals on Electron Microscopy of Kidney Biopsy for Acute Kidney Injury |
| title_fullStr | Methotrexate Crystals on Electron Microscopy of Kidney Biopsy for Acute Kidney Injury |
| title_full_unstemmed | Methotrexate Crystals on Electron Microscopy of Kidney Biopsy for Acute Kidney Injury |
| title_short | Methotrexate Crystals on Electron Microscopy of Kidney Biopsy for Acute Kidney Injury |
| title_sort | methotrexate crystals on electron microscopy of kidney biopsy for acute kidney injury |
| topic | Methotrexate acute renal failure kidney biopsy ultrastructure electron microscopy nephropathology |
| url | http://www.sciencedirect.com/science/article/pii/S2590059524001353 |
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