Morphological spectrum of lesions in renal biopsies with diagnostic role of Immunofluorescence
A study in a tertiary care centre
DOI:
https://doi.org/10.21276/apalm.2439Keywords:
Renal biopsies, histomorphology, immunofluorescenceAbstract
Background: Renal diseases are common causes of morbidity in clinical practice and their incidence is on rise. Glomerulonephritis constitutes nearly 60% of all non-surgical renal diseases and accounts for a substantial number of cases of end stage renal disease.
Objectives: This study was done to analyse the histomorphology of renal diseases. Specific immunofluorescence patterns were also studied as an aid to diagnose various lesions.
Materials and methods: This study was done for a period of six months between January 2017 and June 2017. A total of 30 renal biopsies were received in the Department of Pathology, Coimbatore Medical College, Coimbatore. The tissues were subjected to light microscopic examination and immunofluorescence studies.
Results: Among the total 30 renal biopsies, the most common age group affected was between 31 years and 40 years. The most common age group affected was between 31 years to 40 years. Females (51.72%) were slightly more affected than males (48.27%). Out of 30 cases, 23 (79.31%) showed primary glomerular lesions, 5 (17.24%) showed secondary glomerular lesion and 2 (3.45%) showed tubulointerstitial nephritis. Diffuse proliferative glomerulonephritis was the most common primary glomerular lesion with a total of 6 out of 30 cases (22.41%). Lupus nephritis was the most common secondary glomerular lesion with a total of 4 out of 30 cases (12.07%). Immunofluorescence studies showed positivity in 21 patients accounting for 72.41%. The predominant pattern was granular glomerular basement membrane which was noted in 9 patients (31.03%). The diagnostic utility of IF was noted in 2 cases (6.90%) whose diagnoses included IgA nephropathy and C1q nephropathy. The IF studies helped in modification of the final diagnosis in 1 case (1.72%) whose final diagnosis was lupus nephritis class I.
Conclusion: Immunofluorescence studies have complemented the clinical, histomorphological findings in patients both in primary and secondary glomerular diseases. However, it was even more of diagnostic importance in 5 patients including IgA nephropathy, C1q nephropathy and Lupus nephritis class I where a confident diagnosis could be rendered only because of availability of immunofluorescence studies. Hence, immunofluorescence studies when combined with histomorphologic findings by light microscopy, clinical, biochemical and serological markers can yield a better and precise diagnosis.
References
2. Patrick D. Walker, MD., “The Renal Biopsyâ€., Arch Pathol Lab Med—Vol 133, February 2009., 181-188
3. Louis-Philippe Laurin, Alain Bonnardeaux, Michel Dubé And Martine Leblanc, Chapter 1 “Percutaneous Renal Biopsy†From “Topics in Renal Biopsy and Pathology†Edited by Muhammed Mubarak And Javed I. Kazi, Intech, 2012.3-16.
4. Pierre Simon Et Al, “Epidemiologic Data of Primary Glomerular Diseases in Western Franceâ€, Kidney International, Vol. 66 (2004), Pp. 905–908
5. Ikechi Okpechi, Charles Swanepoel, Maureen Duffield, Bonginkosi Mahala, Nicola Wearne,Stella Alagbe Et Al., “Patterns Of Renal Disease In Cape Town South Africa: A 10-Year Review Of A Single-Centre Renal Biopsy Databaseâ€, Nephrol Dial Transplant (2011) 26: 1853–186.
6. Nasar Yousuf Alwahaibi, Taiseer Ahmed Alhabsi, Samira Abdullah Alrawahi., “Pattern of Glomerular Diseases in Oman: A Study Based On Light Microscopy And Imuunofluorescenceâ€, Saudi Journal Of Kidney Diseases And Transplantation 2013; 24(2): 387-391.
7. Lt Col Gu Deshpande, Rachna Munjal, Col Ramji Rai “Spectrum of nephropathies with special reference to primary glomerulopathies†MJAFI 2000; 56: 125-129.
8. Howard A. Austin Iii, Larry R. Muenz, Kathleen M. Joyce, Tatiana T. Antonovych, And James E. Balow, “Diffuse Proliferative Lupus Nephritis: Identification of Specific Pathologic Features Affecting Renal Outcomeâ€, Kidney International, Vol. 25 (1984), Pp. 689—695
9. Ivan Rychlı´K, Eva JancˇOva´, Vladimı´R Tesarˇ, Alexander Kolsky´, JirˇI´ La´Cha, Josef Stejskal4 Et Al , “The Czech Registry Of Renal Biopsies. Occurrence of Renal Diseases in The Years 1994–2000â€, Nephrol Dial Transplant (2004) 19: 3040–3049
10. Patricia Malafronte1, Gianna Mastroianni-Kirsztajn2, Gustavo N. Betoˆ Nico3, JoaËœO Egı´Dio RomaËœO Jr4, Maria Almerinda R. Alves5, Maria Fernanda Carvalho Et Al., “Paulista Registry Of Glomerulonephritis: 5-Year Data Reportâ€, Nephrol Dial Transplant (2006) 21: 3098–3105.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Veenaa Venkatesh, Vinuta Malaichamy, Vasanthan M K

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).