Pathologic Evaluation of Canine Renal Biopsies: Methods for Identifying Features that Differentiate Immune-Mediated Glomerulonephritides from Other Categories of Glomerular Diseases
Pathologic Evaluation of Canine Renal Biopsies: Methods for Identifying Features that Differentiate Immune-Mediated Glomerulonephritides from Other Categories of Glomerular Diseases
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DOI：
10.1111/jvim.12226
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发表时间：
2013-11-01
影响因子：
2.6
通讯作者：
Lees, G. E.
中科院分区：
文献类型：
--
作者：
Cianciolo, R. E.;Brown, C. A.;Lees, G. E.
背景人类肾活检通常通过使用一组组织学染色的光学显微镜（LM）、透射电子显微镜（TEM）和免疫荧光（IF）显微镜进行评价以获得诊断。相比之下，兽医学中肾小球疾病的病理学评价主要依赖于LM，并且实用性有限。为了解决这个问题，最近建立的兽医肾脏诊断中心采用了人类肾脏病理学中使用的方法来评价肾活检。三大类疾病，这对蛋白尿犬的临床管理有最大的影响，已经建立，包括淀粉样变性，免疫复合物介导的肾小球肾炎（ICGN），和非ICGN。肾活检标本中的IF结果，经验丰富的兽医肾脏病理学家利用这些结果对患有蛋白尿性肾小球疾病的犬进行准确和临床有用的诊断，方法肾活检标本常规行光镜、荧光镜和透射电镜检查。由世界小动物兽医协会肾脏标准化研究组的成员审查样本，以确定诊断或提示所有模式中存在免疫复合物（IC）或淀粉样变性的病变。肾活检evaluations.ResultsEvery方法的调查贡献了重要的研究结果，整合，使一个准确的最终形态学诊断的10个指南。该指南进行了验证，由一个独立的兽医pathologists.Conclusions和临床ImportanceRoutine肾活检与LM，TEM和IF的评价是可行的，必要的，准确的，形态学诊断，可用于指导临床管理的狗肾小球疾病。
BackgroundHuman renal biopsies are routinely evaluated with light microscopy (LM) using a panel of histologic stains, transmission electron microscopy (TEM), and immunofluorescence (IF) microscopy to obtain a diagnosis. In contrast, the pathologic evaluation of glomerular disease in veterinary medicine has relied mostly on LM and was of limited utility. To address this problem, recently established veterinary renal diagnostic centers have adopted methods used in human nephropathology for evaluation of renal biopsies. Three broad categories of disease, which have the greatest implications for clinical management of proteinuric dogs, have been established and include amyloidosis, immune complex-mediated glomerulonephritis (ICGN), and non-ICGN.ObjectiveTo demonstrate histopathologic, ultrastructural, and IF findings in renal biopsy specimens that experienced veterinary nephropathologists utilize to make accurate and clinically useful diagnoses in dogs with proteinuric glomerular disease and to provide guidelines for the proper evaluation of renal biopsies.MethodsRenal biopsy specimens were routinely examined by LM, IF, and TEM. Samples were reviewed by members of the World Small Animal Veterinary Association Renal Standardization Study Group to identify lesions that were diagnostic for, or suggestive of, the presence of immune complexes (IC) or amyloidosis in all modalities. Ten guidelines for renal biopsy evaluation were formulated.ResultsEach method of investigation contributed important findings that were integrated to make an accurate final morphological diagnosis. The guidelines were validated by an independent group of veterinary pathologists.Conclusions and Clinical ImportanceRoutine evaluation of renal biopsies with LM, TEM, and IF is feasible and necessary for making accurate, morphologic diagnoses that can be used to guide clinical management of dogs with glomerular disease.