Spectrum of glomerulonephritides in adults with nephrotic syndrome in Pakistan
Spectrum of glomerulonephritides in adults with nephrotic syndrome in Pakistan
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DOI：
10.1007/s10157-008-0075-0
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发表时间：
2009-02-01
影响因子：
2.3
通讯作者：
Rizvi, Syed Adeebul Hassan
中科院分区：
文献类型：
--
作者：
Kazi, Javed Iqbal;Mubarak, Muhammed;Rizvi, Syed Adeebul Hassan
目前文献中关于这一地区成人肾病综合征肾小球肾炎（GN）模式的信息很少，特别是涉及免疫荧光（IMF）和电子显微镜（EM）的信息。少数研究报告仅基于光镜研究，因此不能反映肾病综合征基础GN的真实模式。我们在巴基斯坦卡拉奇信德泌尿外科和移植研究所（SIUT）的组织学部门进行了这项研究，以首次确定巴基斯坦成人肾病患者GN的真实模式。SIUT是巴基斯坦肾脏和泌尿系统疾病的三级护理中心。SIUT的组织病理学实验室配备了所有的模式，包括EM，所需的肾小球diseases.This精确的诊断是一个回顾性的临床病理研究，涉及检索的临床和病理资料，从原始肾活检报告的成人肾病综合征谁提出了从1996年7月至2006年7月的成人肾脏病诊所SIUT的审查。常规获得两个肾组织芯。一个核心固定在10%福尔马林缓冲液中，并进行光学显微镜检查;另一个核心分为两半，用于EM和IMF研究。其中，201例（63.6%）为男性，115例（36.4%）为女性。平均年龄为28.4 ± 10.51岁，范围为16-78岁。成人肾病患者的病理损害范围很广，包括局灶节段性肾小球硬化（FSGS）其次为膜性肾小球肾炎（MGN）（26.58%），微小病变（MCD）（14.82%）系膜毛细血管性肾小球肾炎（4.3%），系膜增生性GN（4.11%），感染后GN（2.84%），伊加肾病本研究的结果表明，FSGS是成人肾病综合征的最常见病因，其次是MGN和MCD。我们的数据与美国最近一系列报告的数据相似。该研究首次在该地区定义了成人肾病患者肾小球疾病的模式，因为它是基于光学显微镜，血清学，IMF和EM结果。
There is currently little information in literature about the pattern of glomerulonephritides (GN) in adults with nephrotic syndrome in this part of the world, particularly that involving the use of immunofluorescence (IMF) and electron microscopy (EM). A few studies reported are based on light microscopic study alone and hence do not reflect the true pattern of GN underlying nephrotic syndrome. We carried out this study in the Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan to determine, for the first time, the true pattern of GN in adult nephrotic patients from Pakistan. SIUT is a tertiary care center for renal and urologic disease in Pakistan. The Histopathology Laboratory of SIUT is equipped with all the modalities, including EM, required for precise diagnosis of glomerular disease.This is a retrospective clinicopathologic study involving retrieval of clinical and pathological data from a review of original renal biopsy reports of adult patients with nephrotic syndrome who presented at the adult nephrology clinic of SIUT from July 1996 till July 2006. Two cores of renal tissue were routinely obtained. One core was fixed in 10% buffered formalin and processed for light microscopy; the other core was divided into two halves, for EM and the IMF study.A total of 316 adult patients were included. Of these, 201 (63.6%) were male and 115 (36.4%) were female. Mean age was 28.4 +/- A 10.51 years with a range of 16-78 years. The spectrum of pathological lesions in the adult nephrotic population was wide and comprised focal segmental glomerulosclerosis (FSGS) (39.87%), followed by membranous GN (MGN) (26.58%), minimal change disease (MCD) (14.82%), mesangiocapillary GN (4.3%), mesangioproliferative GN (4.11%), post-infectious GN (2.84%), IgA nephropathy (2.53%), and other rare lesions.Results from this study indicate that FSGS is the single most common cause of nephrotic syndrome in adult nephrotic patients, followed by MGN, and MCD. Our data are similar to those reported in recent series from the US. The study defines the pattern of glomerular disease in adult nephrotic patients for the first time in this region, because it is based on light microscopy, serology, IMF, and EM findings.