Tubular and interstitial diseases
Reviewers: Nikhil Sangle, M.D. (see Reviewers page)
Revised: 25 December 2012, last major update March 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.
● Kidney is main route for lead removal from body; lead is absorbed by proximal tubular cells, binds to specific proteins; with acute lead nephrotoxicity in dose-response relationship (Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2010;28:170), these lead-protein complexes are seen as intracellular inclusions (eMedicine)
● Due to occupational (electric storage battery makers, foundrymen, jewelers, painters, welders, ) or environmental causes (children eating lead pain, water in lead pipe systems, lead earthenware, moonshine liquor)
● Lead exposure damages central and peripheral nervous system, GI tract and kidney
● Tubular atrophy and interstitial fibrosis
● Tubular inclusions are eosinophilic and intranuclear or cytoplasmic, acid-fast and red with Giemsa stain
● Arteriolar disease similar to nephrosclerosis
● Tubules disappear in chronic disease; no inflammation
Nonspecific tubular atrophy and interstitial fibrosis, absence of interstitial infiltrate
Lead inclusions in nucleus of tubular cells
Electron microscopy description
● Inclusions are lead-protein complex that appear as compact cores surrounded by loose meshwork of fibrils
End of Kidney non-tumor > Tubular and interstitial diseases > Lead nephropathy
Ref Updated: 8/17/12
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