Nephritis • Hematogenous nephritis – Non-suppurative nephritis
Pathology of the urinary tract Nephritis
Glomerulonephritis • Bacterial ~ – Haematogenous purulent nephritis → later ☺
• Viral ~ – Systemic diseases • newcastle disease, swine fever, infectious canine hepatitis, porcine cytomegalovirus infection – endothelial hypertrophy, necrosis, haemorrhages, mesangium-proliferation
• Chemical ~ – Adriamycin, cyclosporin A, hyperimmune sera, gold, d-penicillamine
• Immunological ~ – Immuncomplex ~ – Nephrotoxic ~
• Glomerulonephritis • Interstitial nephritis
– Suppurative nephritis
• Urinogenic nephritis
Glomerulonephritis • Immune complex glomerulonephritis – Type III. hypersensitivity reaction
• Nephrotoxic glomerulonephritis – Type II. hypersensitivity reaction
• Features • enlarged, moist, pale kidneys with many petechiae in the cortex (glomeruli) • exsudation, infiltration, cell proliferation, sclerosis, basement membrane damage, capillary necrosis, fibroblast proliferation
Immune complex glomerulonephritis • Chronic bacterial infections – Endocarditis, polyarthritis, endometritis
• Viral infections – SP, ASP, BVD, EIA, FIP, FIV/FeLV ☺
• Parasitic conditions – Dirofilariosis
• Autoimmune diseases – Systemic lupus erythematosus, autoimmune hemolytic anaemia
• Neoplasia
Nephrotoxic glomerulonephritis • Cytotoxic hypersensitivity reaction • Binding of specific antibodies to cell surface antigens – Blood group antigens – transfusion! – Goodpasture syndrome – Myasthenia gravis
Type III hypersensitivity reaction
Immune complex glomerulonephritis • Histopathological forms – (Exsudative glomerulonephritis) – Proliferative glomerulonephritis • proliferation of mesangial cells, endothelial cells, epithelial cells
– Membranous glomerulonephritis – Membraneproliferative glomerulonephritis – Glomerulosclerosis
Type II hypersensitivity reaction
Membranosus GN
IC Exsudative glomerulonephritis
Pathology of the urinary tract
Exsudative glomerulonephritis, cattle
Exsudative glomerulonephritis, swine
Porcine dermatitis nephropathy syndrome
Pathology of the urinary tract
Pathology of the urinary tract
Mesangial cell Endothelial cell
Mesangial cell proliferative glomerulonephritis
Membrane proliferative glomerulonephritis
Nephritis • Hematogenous nephritis – Non-suppurative nephritis • Glomerulonephritis • Interstitial nephritis
– Suppurative nephritis
• Urinogenic nephritis
Interstitial nephritis • „Tubulointerstitial nephritis” – tubular epithelial damage → interstitial nephritis
• Acute – subacute – chronic • Infectious – non-infectious origin • Features – diffuse or multifocal greyish-white discolouration in the cortex and medulla – lymphoplasmacytic cellular infiltration • histiocytes, giant cells might be also present • some neutrophil granulocyte in the acute phase • fibrosis, glomerulosclerosis in chronic cases
Interstitial nephritis • Leptospirosis – Leptospira interrogans var. canicola, pomona, icterohaemorrhagiae, hardjo etc. – Pathogenesis • • • •
leptospiraemia localisation in capillaries migration into tubular lumens survival in epithelial cells of proximal and distal convoluted tubules, damage of these structures • diffuse interstitial nephritis
Interstitial nephritis • Canine infectious hepatitis – Canine adenovirus 2 (CAV-2) – Pathogenesis • viral glomerulitis, glomerulonephritis • localisation and persistence in tubular epithelial cells (inclusion bodies!) • tubular epithelial necrosis • chronic lymphoplasmocytic nephritis
Interstitial nephritis • • • • •
Canine herpesvirus infection Sheep pox Equine arteriitis Malignant catarrhal fever PCV-2, PRRS virus
Postweaning multisystemic wasting syndrome, PCV-2, pig
Interstitial nephritis, PCV-2 infection, pig
Interstitial nephritis, PCV-2 infection, pig
Granulomatous nephritis • Mycobacteriosis – „Nephritis tuberculosa caseosa” – „Nephritis tuberculosa proliferativa”
Interstitial nephritis, PCV-2 infection, pig
Granulomatous nephritis • Granuloma formation – Macroscopically visible foci dispersed mainly in the cortex – Characteristic granulomatous cell proliferation • lymphocytes, histiocytes, giant cells, eosinophil and/or neutrophil granulocytes, fibroblasts
– Differential diagnosis → neoplasia!
Granulomatous nephritis • Viruses – Feline coronavirus (FIP) • mainly in „dry” form: pyogranulomatous vasculitis
• Fungi – Aspergillus sp., Histoplasma sp.
• Parasites – Toxocara sp. - dogs
• Protozoa – Encephalitozoon cuniculi - rabbit
• Plant toxins – fodder vetch (Vicia villosa, hairy vetch) - cattle
FIP, cat
Hairy vetch poisoning, cattle
Nephritis
Suppurative nephritis • Embolic suppurative nephritis (glomerulitis)
• Hematogenous nephritis – Non-suppurative nephritis
– Pathogens
• Glomerulonephritis • Interstitial nephritis
• • • • • •
– Suppurative nephritis
• Urinogenic nephritis
Actinobacillus equuli Erysipelothrix rhusiopathiae Actinomyces pyogenes Corynebacterium pseudotuberculosis Francisella tularensis Pasteurella multocida
Pathology of the urinary tract
Nephritis • Hematogenous nephritis – Non-suppurative nephritis • Glomerulonephritis • Interstitial nephritis
Hematogenous suppurative (embolic) nephritis
– Suppurative nephritis
• Urinogenic nephritis (pyelonephritis)
Pathology of the urinary tract
Pyelonephritis • Features – Exsudate accumulation in the pelvis – Inflammation, necrosis of calyces – Tubulointerstitial inflammation – Asymmetric deposition of fibrotic tissue – Pyonephros, perinephric abscess
Ascending pyelonephritis
Pyelonephritis • Predisposing factors – Urocystitis – Stasis of urine, urine abnormalities – Iatrogenic – Developmental anomalies of calyces, pelvis or ureteric valves – Vesicoureteral reflux
Pyelonephritis • Ascending infection – Pathogens • • • • • • • •
Escherichia coli Enterobacter spp. Pseudomonas spp. Proteus spp. Corynebacterium renale Actinobaculum suis Streptococcus spp., Staphylococcus spp. Mixed infections