RENAL GRANULOMAS IN SYSTEMIC VASCULITIS

Renal granulomas are a relatively infrequent finding in the kidney bio psy. They have been described in a number of syndromes such as Wegener 's granulomatosis, anti-GBM glomerulonephritis, and sarcoidosis, and a re commonly believed to be indicative of a fulminant clinical course. In leading textbooks, diverse definitions of renal granulomas are pres ented, which has led to controversies in identifying them. This, in co mbination with their rare occurrence, makes it difficult for the gener al pathologist to identify them. We present the clinical data of 16 pa tients with renal granulomas, from a total group of 157 patients with systemic vasculitis. Their renal functioning was not significantly dif ferent from the other 141 patients in whose renal biopsies renal, gran ulomas were absent. Furthermore, we present two practical definitions for the recognition of renal granulomas in the kidney biopsy, and we s how a number of examples of their various histopathological shapes.