Demographic and Clinicopathologic features of membranous glomerulonephritis. 2004

Najamul Sahar Azad, and Suhail Muzaffar, and Shahid Pervez, and Asim Ahmed, and Anas Rabbani, and Akhter Ali
Department of Pathology and Medicine, The Aga Khan University Hospital, Karachi. saharimran@aku.edu

OBJECTIVE To determine the frequency of membranous glomerulonephritis(MGN) in the renal biopsy specimens. To observe the presenting features and the demographics to determine association, if any, between MGN and hepatitis B in these patients. METHODS Descriptive study. METHODS The section of histopathology, The Aga Khan University Hospital, Karachi over a period of three years (May 1999-April 2002). METHODS All consecutive percutaneous renal biopsy specimens received during the study period were included. A total of 1590 renal biopsy specimens were evaluated. All cases where a definitive diagnosis of MGN (stage II to IV) was made on light and/or immunofluorescence studies were included in the results. Twenty-eight cases were excluded owing to inadequate material. Cases with a presumptive diagnosis and those in stage I of MGN were also excluded. Laboratory investigations carried out include urine examination, blood urea nitrogen. (BUN), serum creatinine, 24 hours urinary protein, Hepatitis B sAg, serological tests for hepatitis C virus, ANA, dsDNA, etc. Clinical features and results of laboratory analysis were recorded along with light microscopic features and statistical analysis was carried out. RESULTS Out of 1562 renal biopsy specimens, 835(53.4%) cases showed primary glomerular pathology. 741(47.4% of the total) cases presented with nephrotic syndrome. Out of these in 176 cases (23.75%), findings were those of membranous glomerulonephritis followed by amyloidosis and focal segmental glomerulosclerosis. Among the cases with MGN, 23(13%) cases were those of secondary MGN whereas 87% were grouped under primary MGN. The male to female ratio was 2.2:1. Mean age at presentation was 29 years, median 29 years and a mode of 30 years. Nineteen cases (1.07%) were seen in children of 14 years old or less. CONCLUSIONS The frequency of MGN was much higher in our study subjects as compared to most other regional studies. No significant association with hepatitis B was seen with only 4 out of 89 cases showing positivity for HBsAg. The pattern of disease corresponds more to that seen in the west.

UI MeSH Term Description Entries
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009404 Nephrotic Syndrome A condition characterized by severe PROTEINURIA, greater than 3.5 g/day in an average adult. The substantial loss of protein in the urine results in complications such as HYPOPROTEINEMIA; generalized EDEMA; HYPERTENSION; and HYPERLIPIDEMIAS. Diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction. Childhood Idiopathic Nephrotic Syndrome,Frequently Relapsing Nephrotic Syndrome,Multi-Drug Resistant Nephrotic Syndrome,Pediatric Idiopathic Nephrotic Syndrome,Steroid-Dependent Nephrotic Syndrome,Steroid-Resistant Nephrotic Syndrome,Steroid-Sensitive Nephrotic Syndrome,Multi Drug Resistant Nephrotic Syndrome,Nephrotic Syndrome, Steroid-Dependent,Nephrotic Syndrome, Steroid-Resistant,Nephrotic Syndrome, Steroid-Sensitive,Nephrotic Syndromes,Steroid Dependent Nephrotic Syndrome,Steroid Resistant Nephrotic Syndrome,Steroid Sensitive Nephrotic Syndrome,Steroid-Dependent Nephrotic Syndromes,Steroid-Resistant Nephrotic Syndromes,Steroid-Sensitive Nephrotic Syndromes,Syndrome, Nephrotic,Syndrome, Steroid-Sensitive Nephrotic
D010154 Pakistan A country located in southern Asia, bordering the Arabian Sea, between India on the east and Iran and Afghanistan on the west and China in the north. The capital is Islamabad. Islamic Republic of Pakistan
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006509 Hepatitis B INFLAMMATION of the LIVER in humans caused by a member of the ORTHOHEPADNAVIRUS genus, HEPATITIS B VIRUS. It is primarily transmitted by parenteral exposure, such as transfusion of contaminated blood or blood products, but can also be transmitted via sexual or intimate personal contact. Hepatitis B Virus Infection
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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