Authors: K. Hušek; D. Sobotová Authors‘ workplace: I. patologickoanatomický ústav MU, Brno Published in: Čes.-slov. Patol., , 2000, No. 2, p. 65-70 Category:
Malakoplakia is an uncommon inflammatory condition rarely involving parenchyma of transplan-ted kidney. We report a 44-year-old female recipient of a cadaveric renal allograft treated withcyclosporin A and prednison. After transplantation, E. coli and Citrobacter bacteruria occuredand three years later decreased graft function developed. Percutaneous needle biopsy was perfor-med and diagnosis of malakoplakia was established. Histologically, interstitial sheets of plasmo-cytes and histiocytes with periodic acid-Shiff positive cytoplasm containing Michaelis-Gutmannbodies were present. Ultrastructurally, phagolysosomes containing membrane fragments and va-rious developmental stages of inclusions to fully developed Michaelis-Gutmann bodies werefound. The patient was treated with co-piperacillin and subsequently pefloxacin and renal functi-ons improved after six months follow-up. Our case suggests that malakoplakia represents anabnormal defective histiocytic response to the infection in the setting of immunosuppressivetherapy.
Key words: malakoplakia-kidney transplantation - diagnosis, kidney disease - pathology - needle
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