PMC3140202_01
(a) Renal biopsy on hospital day 8 demonstrating focal marked acute tubular injury with cell sloughing seen in the tubular lumena (hematoxylin-eosin,  X400). (b) Renal biopsy demonstrating tubulointerstitial nephritis; mild oedema and a focal chronic inflammatory infiltrate (arrows) present with some evidence of acute tubular injury. Cellular and granular cast formation (at left)  (hematoxylin-eosin, X200).
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The biopsy showed an acute tubulointerstitial pathology characterised by focal, but marked, acute tubular injury (Figure 1(a)), with cell sloughing and a mild tubulointerstitial nephritis (Figure 1(b)).
(a) Oxalate crystals (arrows) in tubular epithelium and lumena under normal light (Original magnification X400). (b) Calcium oxalate crystals ( ) in tubular epithelium and lumena under polarised light (Original magnification X400).
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Additionally, the presence of numerous oxalate crystals within both the tubular lumina and the tubular epithelial cells was confirmed under polarized light (Figures 2(a) and 2(b)).