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Category: Volume 09 Issue 03 March 2021
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Title: Morphological pattern of glomerular diseases and its correlation with immunofluorescence findings and clinical presentation

Authors: Nur-E-Jannatul Ferdous, Md. Golam Mostofa, Dabashis Patowary, SK. Md. Jaynul Islam, Tania Gaffar, Sabina Yeasmin, Md. Nasimul Islum,  Enamul Kabir, Harunur Rashid Khan

 DOI: https://dx.doi.org/10.18535/jmscr/v9i3.34

Abstract

Introduction: The renal biopsy is a very important tool for the evaluation of patients with medical and surgical renal diseases.

Materials & Methods: A prospective, cross-sectional and descriptive study was conducted in the Department of Pathology, Sir Salimullah Medical College, Dhaka, Bangladesh and Histopathology Department of Armed Forces Institute of Pathology (AFIP), Dhaka, Bangladesh over a period of 2 years from July 2015 to June 2017. Patients of different age group and both sex were selected for this study according to inclusion and exclusion criteria. Inclusion criteria was histologicaly proven glomerular disease. The exclusion criteria were, HIV infection, Nephrectomy.    Solitary kidney, Intravenous drug abuse.

Results: Present study included 119 cases of histologically proven glomerular disease, the age range of the patients was 3-67 years, 65 were male and 54 were female. Minimal change disease was found to be the most common diagnosis followed by membranoproliferative and IgM nephropathy. Nephrotic syndrome was the most common clinical presentation. Most common immune deposition was IgG Among 119 cases 11.76% was diffuse proliferative glomerulonephritis, 3.36% crescentic glomerulonephritis, 10.93% membranous glomerulonephritis, 13.44% minimal change disease, 7.56% focal segmental glomerulsclerosis, 12.60% membranoproliferative glomerulonephritis, 10.08% IgA nephropathy, 1.68% C1q nephropathy, 5.04% C3 glomerulopathy, 12.61%IgM nephropathy and 10.93% lupus nephritis).

Conclusion: In this study we addressed IgM nephropathy, C3 glomerulopathy, C1q nephropathy as well as IgA nephropathy mostly based on Immunofluorescence findings. As now various type of immunotherapy are introduced in the therapeutic world and glomerular diseases are mostly immune mediated. It’s a new hope for renal disease. The recent availability of an anti-complement agent (eculizumab) has allowed to consider therapeutic options for C3 glomerulopathy.

Keyword:  IgA nephropathy, IgM nephropathy, C1q nephropathy, C3 glomerulopathy.

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Corresponding Author

Dr Nur-E-Jannatul Ferdous

Associate Professor, Department Of Pathology, Ashiyan Medical College, Dhaka