Histopathological spectrum of childhood nephrotic syndrome in Pakistan.
BACKGROUND
There is no information in international literature on the pattern of glomerulopathies in children with idiopathic nephrotic syndrome (INS) in Pakistan. We undertook this study to determine the pattern of glomerulopathies based on renal biopsies studied by light (LM), immunofluorescence (IF), and electron microscopy (EM).


METHODS
The study was conducted at Sindh Institute of Urology and Transplantation (SIUT), Karachi over 12 years (1996-2008). All children (<or=18 years) with INS in whom renal biopsy was performed were included. Renal biopsies were studied by LM, IF, and EM.


RESULTS
Of 538 children, 347 (64.4%) were male and 191 (35.5%) were female. Mean age was 9.79 +/- 4.59 years. The histopathological lesions comprised: minimal change disease (MCD) and its variants, 43.8%; focal segmental glomerulosclerosis (FSGS), 38.14%; membranous glomerulonephritis (GN) (MGN), 7.96%; mesangioproliferative GN (MesPGN), 4.81%; mesangiocapillary GN (MPGN), 3.14%; IgA nephropathy (IgAN), 1.11%; and other rare lesions.


CONCLUSIONS
MCD and its variants are the leading cause of overall INS in children, followed by FSGS, which is the predominant pathology in steroid-resistant and adolescent nephrotic syndrome (NS). Our data are in accordance with recent series from around the world with similar biopsy indications. The study defines the true pattern of glomerulopathies in childhood INS for the first time in Pakistan.
Mubarak
Muhammed
M
Department of Histopathology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan. drmubaraksiut@yahoo.com
Lanewala
Ali
A
Kazi
Javed Iqbal
JI
Akhter
Fazal
F
Sher
Atika
A
Fayyaz
Amir
A
Bhatti
Sajid
S
D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005455:Fluorescent Antibody Technique; D005922:Glomerulonephritis, IGA / Q000473:pathology; D015433:Glomerulonephritis, Membranous / Q000473:pathology; D005923:Glomerulosclerosis, Focal Segmental / Q000473:pathology; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000473:pathology*; D010154:Pakistan; D013256:Steroids / Q000627:therapeutic use
D013256:Steroids