Another look at the nephrotic syndrome in adult Nigerians: pathological and immunological findings.
One hundred and twenty adult Nigerians with the nephrotic syndrome were subjected to similar pathological investigations which included light microscopy and immunoperoxidase study of renal biopsy specimens, serum immunoglobulins and C3c levels. Histological findings showed a wide range of changes with the minimal change type of lesion and proliferative glomerulonephritis accounting each for 33.3 percent of cases studied. Focal changes accounted for 26.3 percent of cases. Glomerular immune deposits were present in 78.6 percent of cases showing non-minimal change glomerular lesions. Serum IgG and IgA were significantly depressed when compared with matched controls (P less than 0.05 and P less than 0.01 respectively) while IgM levels were significantly increased, (P less than 0.001). There was no significant difference between the mean values of serum C3c in the nephrotic group and matched control group. This study shows the high incidence of minimal change nephropathy in our adult population. Although some immunoglobulin (especially IgM) may be identified in occasional glomeruli and cause uncertainty as to the diagnosis, such minor deposition of IgM which is often non specific does not preclude a diagnosis of minimal change nephropathy.
Oviasu
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Department of Medicine, University of Benin Teaching Hospital, Nigeria.
Ojogwu
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D000293:Adolescent; D000328:Adult; D001706:Biopsy; D015932:Complement C3c / Q000032:analysis; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007124:Immunoenzyme Techniques; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D009549:Nigeria / Q000453:epidemiology; D016036:Seroepidemiologic Studies
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D015932:Complement C3c