Nephrotic syndrome among children in Kano: A clinicopathological study
Nephrotic syndrome among children in Kano: A clinicopathological study
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DOI：
10.4103/1119-3077.130247
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发表时间：
2014-05-01
影响因子：
0.9
通讯作者：
Atanda, A. T.
中科院分区：
文献类型：
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作者：
Obiagwu, P. N.;Aliyu, A.;Atanda, A. T.
目的：评价尼日利亚北方儿科肾病科就诊的肾病综合征儿童的临床病理特征。材料与方法：所有15岁以下的肾病综合征儿童和曾在卡诺Aminu Kano教学医院接受肾活检的儿童都进行了研究。他们的组织学诊断与临床和其他实验室参数一起进行评价。结果：20名儿童，17名男性和3名女性，进行了研究。这些患者占研究期间在儿科肾病科就诊的所有肾病综合征患儿的55%，其余患者从未进行过肾活检。高峰年龄为7-8岁（范围2.5-13岁）。20名儿童中有14名（70%）以前曾接受过类固醇治疗。其中，11例（55%）被归类为类固醇耐药，3例（15%）是频繁复发者。6名（30%）儿童新诊断为肾病综合征，尚未开始类固醇治疗。7名（35%）儿童患有高血压。16名儿童（80%）有镜下血尿表现。最常见的组织病理学诊断为9例（45%）儿童的局灶性肾小球硬化症（节段性= 8例;全局性= 1例）。在4名儿童（20%）中发现微小病变，在3名儿童（15%）中发现膜增生性肾小球肾炎，在3名儿童（15%）中发现膜性肾病，在1名儿童（5%）中发现弥漫性系膜细胞增生。在开始类固醇治疗前进行肾活检的6名儿童中，3名（50%）被发现患有肾小球硬化症。结论：局灶节段性肾小球硬化是本研究中在Kano肾病综合征儿童中诊断的最常见的组织学亚型。
Objective: To evaluate the clinicopathological features of children with nephrotic syndrome seen in a pediatric nephrology unit in northern Nigeria. Materials and Methods: All children less than 15 years of age who had nephrotic syndrome and who had been subjected to renal biopsy at Aminu Kano Teaching Hospital, Kano, were studied. Their histologic diagnoses were evaluated alongside clinical and other laboratory parameters. Results: Twenty children, 17 males and three females, were studied. These represented 55% of all children with nephrotic syndrome seen in the pediatric nephrology unit during the study period, the rest of which have never had renal biopsies. Peak age was 7-8 years (range 2.5-13 years). Fourteen of the 20 children (70%) had previously been on steroid treatment. Of these, 11 (55%) were classified to be steroid resistant and three (15%) were frequent relapsers. Six (30%) children were newly diagnosed with nephrotic syndrome and had not commenced steroid treatment. Hypertension was found in seven (35%) children. Sixteen children (80%) had microscopic hematuria on presentation. The most common histopathological diagnosis was focal glomerulosclerosis in nine (45%) children (segmental = 8; global = 1). Minimal change disease was found in four children (20%), membranoproliferative glomerulonephritis in three children (15%), membranous nephropathy in three children (15%), and diffuse mesangial hypercellularity in one child (5%). Of the six children who had renal biopsy before commencement of steroid treatment, three (50%) were found to have glomerulosclerosis. Conclusion: Focal segmental glomerulosclerosis was the most common histological subtype diagnosed in Kano among children with nephrotic syndrome in this study.