title: Correlates of hematuria on glomerular histology and electron microscopy in IgA nephropathy.
abstract: BACKGROUND
  Hematuria is the most important clinical manifestation of IgA nephropathy. This study was undertaken with the objective to describe the spectrum of histological changes with reference to the Oxford classification and the ultrastructural changes in the glomerular basement membrane and to correlate them with hematuria.
  
  
  METHODS
  66 patients who underwent renal biopsy for IgA nephropathy were evaluated histologically by the Oxford system and also subject to electron microscopic examination for glomerular immune deposits, as well as alterations in the glomerular basement membrane.
  
  
  RESULTS
  On comparing the histological scores generated by the Oxford classification with degree of hematuria, it was found that the status of 'endocapillary proliferation' and the status of 'tubular atrophy and interstitial fibrosis showed a significant correlation. Correlation of hematuria with location of the deposits, i.e. mesangial only, and mesangial with capillary wall deposits (subendothelial and subepithelial) did not show any association. Other alterations of the GBM were seen in 12 cases. The changes included thinning alone in 4 cases, thinning and lamellar splitting in 5 cases, and lamellar splitting alone in 2 cases.
  
  
  CONCLUSIONS
  At presentation, endocapillary proliferation is one histological parameter which shows close association with hematuria.
authors.affiliation: Assistant Professor, Dept of Pathology, Armed Forces Medical College, Pune 411040, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Tewari
authors.affiliation: Addl Professor (Histopathology), PGIMER, Chandigarh, India.
authors.forename: Ritambhra
authors.initials: R
authors.lastname: Nada
authors.affiliation: Senior Resident (Histopathology), PGIMER, Chandigarh, India.
authors.forename: Maninder
authors.initials: M
authors.lastname: Kaur
authors.affiliation: Assistant Professor, Dept of Community Medicine, Armed Forces Medical College, Pune 411040, India.
authors.forename: Puja
authors.initials: P
authors.lastname: Dudeja
authors.affiliation: Chief Technician & Electronmicroscopist, (Histopathology), PGIMER, Chandigarh, India.
authors.forename: Charan Singh
authors.initials: CS
authors.lastname: Rayat
authors.affiliation: Ex Professor & Head (Nephrology), PGIMER, Chandigarh, India.
authors.forename: Vinay
authors.initials: V
authors.lastname: Sakhuja
authors.affiliation: Ex Professor & Head, (Histopathology), PGIMER, Chandigarh, India.
authors.forename: Kusum
authors.initials: K
authors.lastname: Joshi
keywords: Electron microscopy; Hematuria; IgA nephropathy; Oxford classification