Histopathological pattern in childhood glomerulonephritis

Abstract

Objectives: To determine the histopathological pattern in childhood glomerulonephritis (CGN).

Methods: This retrospective analysis of renal biopsies of 118 children with various clinical syndromes of CGN was carried out at the National Institute of Child Health (NICH) and The Kidney Center (TKC), Karachi, from July 2005 to December 2009. The age ranged from 6 months to 16 years. All biopsies were studied under light microscopy (LM) and immunoflourescence (IMF). Histopathological lesions (HPL) were classified as primary and secondary glomerular diseases. Demographic data, indications and HPL were retrieved and analyzed using descriptive statistics.

Results: Out of 118 patients, 62 (52.54%) were males and 56(47.45%) females. Mean age was 8.2 +/- 3.9 years. Major indications for biopsy were primary nephrotic syndrome (PNS 86, 72.88%). secondary GN (SGN, 17, 14.4%) and nephritic-nephrotic syndrome (NNS 13, 11%). Overall, primary glomerular diseases (PGD) accounted for 84.74% of all biopsies. Minimal change disease (MCD 38, 32.2%) and focal segmental glomerulosclerosis (FSGS 35, 29.66%) were the two most common lesions and accounted for 43% and 33.72% respectively in PNS. Other important lesions were membranous GN (MGN 10, 8.47%), membranoproliferative (MPGN 9, 7.16%), post-infective (PIGN 4, 3.38%) and IgM nephropathy (IgMN 3, 2.54%). Among secondary glomerular diseases (SGD), lupus nephritis (LN 11, 9.32%) was the most common lesion followed by Henoch-Schonlein nephritis (HSN) and haemolytic uraemic syndrome (HUS) each in 3 (2.52%).

Conclusion: Overall, MCD and FSGS were the two most common HPL in PGD and both dominated in PNS. Lupus nephritis was the leading lesion in SGD. These histopathological pattern of CGN in our study is in conformity with the existing literature from Pakistan.