Abstract

HISTOPATHOLOGICAL SPECTRUM OF PAEDIATRIC RENAL DISEASE IN AND AROUND VARANASI

Dr. Usha, Dr. Anju Bharti*, Dr. Jai Prakash, Dr. Shivendra Singh, Dr. O. P. Mishra, Dr. R. G. Singh, Dr. Narrendran A. P, Dr. Aparajita Goel, Dr. Manoj Paswan

Abstract

Morphological pattern of renal disease varies from place to place and is governed by mostly environmental factors and to some extent by genetic factor. Aim of the study was to find out morphological spectrum of renal diseases in children and its correlation with clinicopathological features. Histopathological study of renal biopsies showed that mesangioproliferative(glomerulonephritis(GN) were the most common GN in children seen in 31.10% cases. Next common GN was FSGS(Focal segmental glomerolosclerosis,18.8%)followed by minimal change disease GN, Membranoproliferative GN (11.29%) each, Diffuse proliferative GN (9.67%),Cresentic GN (4.30%), membranous GNand end stage renal disease(2.15%)each. Among Secondary GN, lupus nephritis (LN)was the most common. Hyaline thrombi in glomerular capillaries were most common in membranous GN(50%) followed by LN(20.17%) and Minimal change GN (14.28%) and FSGS each. Microscopic hematuria was most common in CGN (62.50%). Granuloma in interstitium were found in more than 1/3rd cases of MPGN (38%), followed by cresentic GN (37.50%), Lupus nephritis (13.33%) and diffuse mesangioproliferative GN (12%). Thrombi in medium sized blood vessels was seen in 50% cases of MGN, 16.66% cases of diffuse proliferative GN, 14.28% cases of FSGS & 50% cases of pyelonephritis. Thus our study concludes that Mesangio proliferative GN is the most common in paediatric GN. Presence of more venulitis, vasculitis & thrombosis in blood vessels of MGN suggest that probably vascular lesion due to both cell mediated immunity (venulitis) and humoral immunity (vasculitis) leading to thrombosis may be involved in pathogenesis of MGN.

Keywords: Renal lesions in pediatric age group, glomerulonephritis, membranousGN, Lupusnephritis, membranoproliferative GN, mesangioproliferative GN.