Histopathological Patterns of Nephrotic Syndrome in a Tertiary Care Center in Ile-Ife, Southwestern Nigeria: A 16-Year Retrospective Study
Asian Journal of Research in Nephrology, Volume 6, Issue 1,
Page 1-8
Abstract
Background: Nephrotic syndrome is one of the major ways in which kidney disease presents clinically the world over. Where biopsies are carried out, the microscopic appearances observed in the affected patients vary according to age, gender, race and geographical location. In most cases, the vital information obtained from the histological assessment of these patients is pivotal to instituting effective management of their diseases.
In this study, we set out to describe the spectrum of microscopic findings in renal biopsies obtained from nephrotic syndrome patients in our hospital between January 2002 to December 2017.
Methodology: Archival formalin-fixed-paraffin-embedded renal biopsy tissue blocks were subjected to routine Heamatoxylin & Eosin(H&E), Jones Methelamine Silver (JMS), Masson’s Trichrome (MT) and Periodic Acid Schiff stains (PAS) as well as immunoperoxidase stains for IgG, IgM, IgA and C3. The slides were viewed using binocular light microscope.
Results: A total of 73 cases were reviewed with a male to female ratio of 1.7:1 and mean age of 20.2 years SD of 11.6). Overall, focal segmental glomerulosclerosis (FSGS) (48.3%) was the most frequent histological pattern observed. FSGS and minimal change disease were the commonest histological patterns seen in children while FSGS and membranous glomerulopathy were the most common patterns in adult population. There were four cases of IgA nephropathy on immunoperoxidase stain. The previous diagnosis was changed in 13 cases, with use of immunostaining which was not carried out ab initio.
Conclusion: This study shows that FSGS is the most common histopathological finding among patients with the nephrotic syndrome in our hospital irrespective of age or gender. In addition, we found that the use of immunoperoxidase in assessment of renal biopsy is important in making a more accurate and clinically relevant diagnosis.
- Nephrotic syndrome
- renal
- biopsies
- patterns
- histopathological
How to Cite
References
Gesualdo L, DiPalma AM, Morrone LF, Strippoli GF, Schena FP. Italian Immunopathology Group, Italian Society of Nephrology. The Italian experience of the national registry of renal biopsies. Kidney Int. 2004;66:890-4.
Charles EA. Glomerular diseases. In: Kumar.V, Fausta. N, Aster.J AK, editor. Robbins and Cotran Pathological Basis of Disease. 8th ed. Philadelphia: Saunders Elsevier. 2010;978–9.
Onwubuya IM, Adelusola KA, Sabageh D, Ezike KN, Olaofe OO. Biopsy- proven renal disease in Ile Ife, Nigeria. A histopathological review. Indian Soc Nephrol. 2016;26(1):17–21.
Hull RP, Goldsmith DJ. Nephrotic syndrome in adults. BMJ [Internet]. 2008; 336(7654):1185–9.
Obiagwu PN, Atanda AT, Aliyu A. Nephrotic syndrome among children in Kano: A clinicopathological study. Niger J Med Pract. 2014;17(3):370–4.
Patricia M et al. Paulista registry of glomerulonephritis: 5-year data report. Nephrol Dial Transplant. 2006;21(11):3098–105.
Okpechi IG, Ameh OI, Bello AK, Ronco P, Swanepoel CR, Kengne AP. Epidemiology of histologically proven Glomerulonephritis in Africa: A systematic review and meta-analysis. Plos One. 2016;11(3):1–15.
Ibrahim S, Fayed A, Fadda S. BD. A five-year analysis of the incidence of glomerulonephritis at Cairo University Hospital-Egypt. Saudi J Kidney Dis Transpl. 2012;23:866–70.
Chijioke A, Adeniyi AB. Clinicopathological study of adult nephrotic syndrome in Ilorin,Nigeria. Niger Med Pract. 2003;43(2):28–32.
Kazi JI, Mubarak M, Ahmed E, Akhter F, Naqvi SAA, Rizvi SAH. Spectrum of glomerulonephritides in adults with nephrotic syndrome in Pakistan. Clin Exp Nephrol. 2009;13(1):38–43.
Caneta PA, Radhakrishnan J. The evidence-based approach to Adult onset Idiopathic Nephrotic syndrome. Vol3. Front peadiatric; 2015.
Umeizudike TI et al. Renal histology pattern in prospective study of nephrology clinics in Lagos NIgeria. Clin Nephrol. 2016;23:354–66.
Asinobi AO, Ademola AD, Okolo CA, Yaria JO. Trends in the histopathology of childhood nephrotic syndrome in Ibadan Nigeria : preponderance of idiopathic focal segmental glomerulosclerosis. BMC Nephrol [Internet]. 2015;1–9.
Available:http://dx.doi.org/10.1186/s12882-015-0208-0
Olowu WA, Adelusola KA, Adefehinti O. Childhood Idiopathic Steroid Resistant Nephrotic Syndrome. Saudi J Kidney Dis Transplant. 2010;21(5):979–90
Obiagwu PN, Atanda AT, Aliyu A. Nephrotic syndrome among children in Kano: A clinicopathological study. Niger J Med Pract. 2014;17(3):370–4.
Doe JY, Funk M, Mengel M, Doehring E, Ehrich E, Jochen HH. Nephrotic syndrome in African children : Lack of evidence for ‘ tropical nephrotic syndrome ’? Nephrol Dial Transpl. 2006;21(December 2005): 672–6.
Oviasu E, Ojogwu L. Another look at the nephrotic syndrome in adult Nigerians: Pathological and immunological findings. West Afr J Med. 1992;11:18–24.
Obiorah CC, Okoro PE, Clinicopathological report of children and young adults with nephrotic syndrome undergoing renal biopsy at workshops in Port Harcourt, Nigeria. African J Nephrology. 2019; 21(1):3-7.
Rico MP et al. Characterization and Etiopathogenic Approach of Pediatric Renal Biopsy Patients in a Colombian Medical Center 200-7-2017. International Journal of Nephrology. 2018; 205-206.
Bonilla-Felix M et al. Changing patterns in the histopathology of idiopathic nephrotic syndrome in children. Kidney Int [Internet]. 1999;55(5):1885–90.
Leal CH, Andrew SB, Micheal BS, Jai R, D’Agati VD, Glen SM. IgA Nephropathy with minimal change disease. CJASN. 2014;9(6):1033-1039.
-
Abstract View: 68 times
PDF Download: 35 times
