Pattern of morphology in renal biopsies of nephrotic syndrome patients. Correlation with immunoglobulin and complement deposition and serology.
OBJECTIVE
To determine the morphological pattern in renal biopsies from nephrotic patients and their correlation with immunoglobulin and complement deposition as detected by immunofluorescence microscopy (IMF) and serology to arrive at correct diagnosis of glomerulonephritis (GN).


METHODS
The study was carried out at the departments of Immunology and Histopathology, Sindh Institute of Urology and Transplantation (SIUT) from April 2007 to March 2008. A total of 200 patients, including children and adults were included. All patients presented with nephrotic syndrome (NS). Clinical and laboratory investigations including serology were noted, renal biopsies performed and studied by light and immunofluorescence microscopy (IMF).


RESULTS
Of 200 patients, 74 (37%) were children (< or = 18 years) and 126 (63%) adults (> or = 19 years). Mean age of children was 11.34 +/- 4.85 years (range 3-18 years) and that of adults was 35.44 +/- 11.4 years (range: 19-70 years). The total percent change in L/M diagnosis after serological tests was 11.5% and after IMF studies, 23.5%. Combined serologic and IMF studies lead to 35% change in L/M diagnosis of the renal biopsies in nephrotic syndrome patients.


CONCLUSIONS
Our results demonstrate that the ancillary techniques of IMF microscopy and serology are indispensable in the elucidation of final specific diagnosis causing nephrotic syndrome in a substantial number of cases and these should be employed routinely in the pathologic evaluation of renal biopsies. The study emphasizes the importance of combined approach in the investigation of renal biopsies in nephrotic syndrome.
Abbas
Khawar
K
Department of Molecular Biology and Immunology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan.
Mubarak
Muhammad
M
Kazi
Javed Iqbal
JI
Muzaffar
Rana
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003167:Complement Activation; D003165:Complement System Proteins / Q000032:analysis* / Q000276:immunology; D005260:Female; D005921:Glomerulonephritis / Q000097:blood / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007136:Immunoglobulins / Q000097:blood* / Q000276:immunology; D007668:Kidney / Q000473:pathology; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000097:blood / Q000276:immunology / Q000473:pathology*; D011446:Prospective Studies; D013223:Statistics as Topic; D055815:Young Adult
D007136:Immunoglobulins; D003165:Complement System Proteins