Published in:
01-12-2009 | Original Article
Histopathological spectrum of childhood nephrotic syndrome in Pakistan
Authors:
Muhammed Mubarak, Ali Lanewala, Javed Iqbal Kazi, Fazal Akhter, Atika Sher, Amir Fayyaz, Sajid Bhatti
Published in:
Clinical and Experimental Nephrology
|
Issue 6/2009
Login to get access
Abstract
Background
There is no information in international literature on the pattern of glomerulopathies in children with idiopathic nephrotic syndrome (INS) in Pakistan. We undertook this study to determine the pattern of glomerulopathies based on renal biopsies studied by light (LM), immunofluorescence (IF), and electron microscopy (EM).
Methods
The study was conducted at Sindh Institute of Urology and Transplantation (SIUT), Karachi over 12 years (1996–2008). All children (≤18 years) with INS in whom renal biopsy was performed were included. Renal biopsies were studied by LM, IF, and EM.
Results
Of 538 children, 347 (64.4%) were male and 191 (35.5%) were female. Mean age was 9.79 ± 4.59 years. The histopathological lesions comprised: minimal change disease (MCD) and its variants, 43.8%; focal segmental glomerulosclerosis (FSGS), 38.14%; membranous glomerulonephritis (GN) (MGN), 7.96%; mesangioproliferative GN (MesPGN), 4.81%; mesangiocapillary GN (MPGN), 3.14%; IgA nephropathy (IgAN), 1.11%; and other rare lesions.
Conclusion
MCD and its variants are the leading cause of overall INS in children, followed by FSGS, which is the predominant pathology in steroid-resistant and adolescent nephrotic syndrome (NS). Our data are in accordance with recent series from around the world with similar biopsy indications. The study defines the true pattern of glomerulopathies in childhood INS for the first time in Pakistan.