Abstract:
BACKGROUND:A striped pattern of fibrosis has been described in the kidneys of patients undergoing long-term cyclosporine or tacrolimus therapy. This lesion is frequently misconstrued as being specific for drug toxicity. METHODS:We performed clinicopathologic correlation on 18 patients with striped fibrosis identified by reviewing 61 biopsies from kidney transplant recipients maintained with tacrolimus. RESULTS:Acute rejection was identified in 14 of 18 patients, chronic rejection in 9 of 18 patients, potential diabetic microvascular injury in 8 of 18, and pre-existing donor disease in 2 of 18. In only one patient could striped fibrosis be ascribed primarily to tacrolimus. Striped fibrosis could also be demonstrated in 6 of 10 late allograft biopsy specimens from patients maintained with only azathioprine, and 8 of 10 native biopsies from patients with advanced diabetes mellitus. CONCLUSION:Multiple insults contribute to the pathogenesis of striped fibrosis in the kidney. This lesion can be attributed entirely to chronic drug toxicity in only a minority of allografts.
journal_name
Transplantationjournal_title
Transplantationauthors
Dell'Antonio G,Randhawa PSdoi
10.1097/00007890-199902150-00025subject
Has Abstractpub_date
1999-02-15 00:00:00pages
484-6issue
3eissn
0041-1337issn
1534-6080journal_volume
67pub_type
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