JPC SYSTEMIC PATHOLOGY
URINARY SYSTEM
January 2018
U-P03

Signalment (JPC Accession # 1752289):  Mixed breed dog

HISTORY:  Tissue from a mixed breed dog with a two-year history of chronic dermatitis with pruritus.  Before death the animal had periodic epistaxis.

HISTOPATHOLOGIC DESCRIPTION: (U-P03a) Kidney:  Multifocally expanding the renal interstitium, separating and surrounding cortical tubules and glomeruli, and expanding the pelvic subepithelial connective tissue, are numerous plasma cells, macrophages, fewer lymphocytes and neutrophils, and occasional homogenous eosinophilic material (proteinaceous fluid).  Macrophages are often expanded by numerous intracytoplasmic 3-4 um round to oval protozoa, which contain 1-2 um diameter, basophilic nuclei with adjacent perpendicular basophilic kinetoplasts (amastigotes).  Multifocally glomeruli have one or more of the following changes: increased numbers of mesangial cells and glomerular capillary loops thickened by eosinophilic, homogenous material (membranoproliferative glomerulonephritis); amastigotes within mesangial cells or macrophages; glomerular tufts adhered to the parietal epithelium (synechia); cuboidal parietal epithelium lining Bowman’s capsule (hypertrophy); surrounded by marked amounts of fibrous connective tissue (periglomerular fibrosis); and uriniferous space expanded by variable amounts of eosinophilic homogenous material (proteinosis). Multifocally, proximal tubules and collecting ducts have one or more of the following changes:  lined by attenuated epithelium; mildly ectatic and contain moderate amounts of proteinaceous material (tubular proteinosis); rarely contain a basophilic, granular material (mineralization).  Multifocally, the subepithelial pelvic connective tissue is expanded by the previously described inflammatory cells including infected macrophages and the overlying epithelium is mildly hyperplastic with occasional transmigration by neutrophils. 

U-P03b:  Kidney (Giemsa):  There is multifocal positive purple staining of amastigote nuclei and adjacent kinetoplasts.

MORPHOLOGIC DIAGNOSIS:  Kidney:  Nephritis, interstitial, lymphoplasmacytic and histiocytic, multifocal, moderate, with membranoproliferative glomerulonephritis, and myriad intrahistiocytic amastigotes, etiology consistent with Leishmania sp., mixed breed, canine.

ETIOLOGIC DIAGNOSIS:  Renal leishmaniasis

CAUSE:  Leishmania sp.

CONDITION:  Visceral leishmaniasis

SYNONYMNS:  Kala-azar, Dum dum fever

GENERAL DISCUSSION:

PATHOGENESIS:

LIFE CYCLE: 

TYPICAL CLINICAL FINDINGS:

CLINICAL PATHOLOGY:

TYPICAL GROSS FINDINGS: 

TYPICAL LIGHT MICROSCOPIC FINDINGS:

ULTRASTRUCTURAL FINDINGS: 

ADDITIONAL DIAGNOSTIC TESTS:

DIFFERENTIAL DIAGNOSIS:

Organisms that may appear similar microscopically:

COMPARATIVE PATHOLOGY:

REFERENCES:

  1. Aresu L, Benali S, Ferro S, et al. Light and electron microscopic analysis of consecutive renal biopsy specimens from Leishmania-seropositive dogs. Vet Pathol. 2013;50(5):753-60.
  2. Baneth G, Solano-Gallego L, Mendez S. Leishmaniases. In: Greene CE, ed. Infectious Diseases of the Dog & Cat. 4th ed. St. Louis, MI: Elsevier Saunders. 2012;734-749.
  3. Brachelente C, Muller N, Doherr MG, et al. Cutaneous leishmaniasis in naturally infected dogs is associated with a T helper-2-biased immune response. Vet Pathol. 2005;42(2):166-75.
  4. Costa FAL, Goto H, Saldanha LCB, Silva SMMS, Sinhorini IL, et al. Histopathologic patterns of nephropathy in naturally acquired canine visceral l Vet Pathol. 2003;40(6):677-84.
  5. Ferri F, Zini E, Auriemma E, et al. Splenitis in 33 dogs.  Vet Pathol.  2017 Jan;54(1):147-154.
  6. Ferro S, Palmieri C, Cavicchioli L, et al. Leishmania amastigotes in neoplastic cells of 3 nonhistiocytic canine tumors.  Vet Pathol.  2013;50(5):749-752.
  7. Koutinas AF, Koutinas CK. Pathologic mechanisms underlying the clinical findings in canine Leishmaniosis due to Leishmania infantum/chagasiVet Pathol.  2014;51(2):527-538.
  8. Mauldin EA, Peters-Kennedy J. Integumentary system. In: Maxie MG, ed. Jubb, Kennedy and Palmer’s Pathology of Domestic Animals. Vol 1. 6th ed. Philadelphia, PA: Saunders; 2016:663-664.
  9. McAdam AJ, Milner DA, Sharpe AH. Infectious diseases. In: Kumar V, Abbas AK, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Philadelphia, PA: Elsevier Saunders. 2015;392-4.
  10. Nascimento MS, Albuquerque TD, Nascimento AF, et al. Impairment of interleukin-17A expression in canine visceral leishmaniasis is correlated with reduced interferon-y and inducible nitric oxide synthase expression.  J Comp Pathol.  2015 Nov;153(4):197-205.
  11. Rosa FA, Leite HAC, Braga ET, et al. Cardiac lesions in 30 dogs naturally infected with Leishmania infantum chagasi Vet Pathol. 2014;51(3):603-6.
  12. Saridomichelakis MN, Koutinas AF. Cutaneous involvement in canine leishmaniosis due to Leishmania infantum (syn. chagasi). Vet Dermatol. 2014; 25(2):61-71.
  13. Valli VEO, Kiupel M, Bienzle D. Hematopoietic system. In: Maxie MG, ed. Jubb, Kennedy and Palmer’s Pathology of Domestic Animals. Vol 3. 6th ed. Philadelphia, PA: Saunders; 2016:174-176.


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