Percutaneous renal biopsy

A 38-year-old woman took norfloxacin (300 mg/day) and tiaramide hydrochloride (300 mg tds) for an infection with Mycoplasma pneumoniae. One day after the start of treatment, her symptoms of cough and fever worsened and she developed lumbago and hematuria. The diagnosis was confirmed by percutaneous renal biopsy. She slowly improved without specific treatment. Lymphocyte stimulation tests were negative, but rechallenge with norfloxacin was followed by bilateral lumbago. 

If the etiology of the ARF is unclear despite a careful history, physical examination, and appropriate diagnostic tests, percutaneous renal biopsy may be indicated. Renal biopsy is associated with some risk (primarily bleeding) and should only be performed in those few patients who meet criteria for biopsy. However, in cases in whom the cause of ARF is not evident, renal biopsies are useful in determining the cause in more than 90% of patients. ... 

Although the cause of glomerular disease may be established from clinical and laboratory evaluation, sometimes percutaneous renal biopsy may be needed to provide a definitive diagnosis. 

Gainza FJ, Minguela I, Lopez-Vidaur I et al (1995) Evaluation of complications due to percutaneous renal biopsy in allograft and native kidneys with color - coded Doppler sonography. Clin Nephrol 43 303-308... 

Karafin L, Lendall AR, Felisher DA (1970) Urologic complications in percutaneous renal biopsy in children. J Urol 103 332-335... 

Yoshikawa N, Ito H, Sakai T et al (1999) A controlled trial of combined therapy for newly diagnosed severe childhood IgA nephropathy. J Am Soc Nephrol 10 23-33 Zeis PM, Spigos DS, Samayoa C (1976) Ultrasound localization for percutaneous renal biopsy in children. J Pediatr 89 263-265... 

Lechevallier E etal. (2000) Fine-needle percutaneous biopsy of renal masses with helical CT guidance. Radiology 216 506-510... 

Fig. 7.17. Image from a 33-year-old man obtained 20 months after simultaneous pancreas-kidney transplantation with pancreatic graft dysfunction and acute rejection verified by histopathological examination. Helical CT is used for image-guided percutaneous biopsy arrows) of pancreatic graft arrow) adjacent to contrast-medium-filled small bowel arrowhead) and renal graft asterisk)...

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