Evaluation of renal biopsies in various kidney diseases with reference to staining

2021 ◽  
Vol 6 (4) ◽  
pp. 269-274
Author(s):  
Kaushlendra Kumar Pandey ◽  
Wilma Delphine Silvia CR ◽  
Aparna Pandey ◽  
Asha Agarwal
Keyword(s):  
Kidney Diseases ◽  
Clinical Signs ◽  
Disease Process ◽  
Membranous Glomerulonephritis ◽  
Signs And Symptoms ◽  
Underlying Disease ◽  
Renal Diseases ◽  
Amyloid Deposits ◽  
Renal Biopsies ◽  
Staining Techniques

Renal diseases of different origin and nature may produce essentially similar disturbances of renal functions and may have clinical similarities and hence there was a need to classify renal diseases more scientifically. The basic approach was to correlate clinical signs and symptoms with histological changes in the tissue, using both simple and special staining techniques so as to reach to a definitive diagnosis.The present study was conducted on renal biopsy referred to pathology department. Criteria for successful biopsy were as follows-Adequate biopsy sample size, correct processing of specimen, informed interpretation and issue of an accurate report. A total of 29 renal biopsies were examined. In minimal change disease, only in 4 patients the glomerulus was sclerosed. Membranous glomerulonephritis comprised of the maximum number of cases (9/30). Total of 3 cases of renal biopsies revealed amyloidosis. Focal amyloid deposits with deposits either near the hilum or perivascular areas were found in 33.3% of cases, while extensive amyloid deposits were found in 33.3% of the cases.It is necessary to determine both the type of renal disease and the cause of the primary disorder in order to make the diagnosis and various staining techniques play a very helpful role. The likelihood that the biopsy specimen accurately reflects the type and severity of the underlying disease is directly related to both the diffuseness of the disease process and the amount of tissue examined.

scholarly journals The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-proven Cases from a Single Centre in China between 1999 and 2019

2021 ◽  
Author(s):  
Li-Jun Jiang ◽  
Xue Zhao ◽  
Zhi-Yan Dou ◽  
Zan-Hua Rong ◽  
Lin Yang
Keyword(s):  
Kidney Disease ◽  
Alport Syndrome ◽  
Kidney Diseases ◽  
Membranous Glomerulonephritis ◽  
Proliferative Glomerulonephritis ◽  
Renal Diseases ◽  
Glomerular Diseases ◽  
Common Cause ◽  
Thin Basement Membrane Nephropathy ◽  
Renal Biopsies

Abstract Background: This study aimed to investigate the clinical and pathological characteristics and the profile of and temporal changes in glomerular diseases in 2403 paediatric renal biopsies from 1999 to 2019.Methods: Renal biopsies performed on children aged ≤18 years between 1999 and 2019 were analysed at our centre. We analysed the clinical and histological characteristics, distribution of paediatric renal diseases with various clinical presentations, and changes in the pattern of kidney disease during the study period.Results: The most common primary glomerular disease was IgA nephropathy (IgAN) (24.3%), followed by minimal change disease (MCD) (15.3%) and membranous glomerulonephritis (MN) (13.1%). Henoch-Schonlein purpura nephritis (HSPN) (18.1%) and lupus nephritis (LN) (7.2%) were the most frequently recorded secondary glomerular diseases. Alport syndrome and thin basement membrane nephropathy (TBMN) were the most common inherited glomerular diseases, accounting for 1.2% and 0.6% of the total glomerular diseases in children, respectively. The number of boys with IgAN, MCD and IgM nephropathy (IgMN) was significantly higher than that of girls, while the number of girls with MN and LN was significantly higher than that of boys. The frequencies of MCD, MN, IgMN and endocapillary proliferative glomerulonephritis (EnPGN) in the 13-18-year-old group were significantly higher than those in the 0-12-year-old group, while the frequencies of IgAN, mesangial proliferative glomerulonephritis (MsPGN) and focal proliferative glomerulonephritis (FPGN) were lower than those in the 0-12-year-old group. The ratio of Alport syndrome and TBMN in the 0-12-year-old group was significantly higher than that in the 13-18-year-old group. The proportion of patients with MCD and MN in 2010-2019 was significantly higher than that in 1999-2009, while the ratio of IgAN, MsPGN, IgMN, EnPGN, membranoproliferative glomerulonephritis (MPGN), HSPN and HBV-associated glomerulonephritis (HBV-GN) decreased. MCD (28.5%) was the most common cause of nephrotic syndrome (NS). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more common than other glomerular diseases. IgAN (39.4%) was the most common cause of AKI. Sclerosing glomerulonephritis (SGN) (21.1%) was the main cause of progressive chronic kidney disease (CKD).Conclusions: Glomerular diseases in children were related to sex and age. From 1999 to 2019, the spectrum of children's kidney disease in our centre changed significantly.

scholarly journals Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis

2017 ◽  
Vol 45 (3) ◽  
pp. 248-256 ◽  
Author(s):  
Fernanda Payan Schober ◽  
Meghan A. Jobson ◽  
Caroline J. Poulton ◽  
Harsharan K. Singh ◽  
Volker Nickeleit ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Disease Process ◽  
Signs And Symptoms ◽  
Patient Characteristics ◽  
Underlying Disease ◽  
Fibrillary Glomerulonephritis ◽  
Black Patients ◽  
End Stage ◽  
20 Nm ◽  
The University

Background: Fibrillary glomerulonephritis is characterized by randomly arranged fibrils, approximately 20 nm in diameter by electron microscopy. Patients present with proteinuria, hematuria and kidney insufficiency, and about half of the reported patients progress to end-stage kidney disease within 4 years. The dependence of patient characteristics and outcomes on race has not been explored. In this study, we describe a cohort of patients with fibrillary glomerulonephritis and compare their clinical characteristics and outcomes with those of patients previously described. Methods: The University of North Carolina (UNC) Nephropathology Database was used to retrospectively identify patients diagnosed with fibrillary glomerulonephritis between 1985 and 2015. Of these patients, those treated at UNC were selected. Their demographic and clinical characteristics - including signs and symptoms, comorbidities, laboratory values, treatments and outcomes - were compared with those of patients described earlier. Results: Among the 287 patients identified, 42 were treated at the UNC Kidney Center. When compared to earlier cohorts, a higher frequency of black race, hepatitis C virus (HCV) infection and use of hemodialysis were noted in both black and HCV-positive patients. Autoimmune diseases, infections and malignancies were frequently observed, present in over half of all cases. Conclusion: According to this study, fibrillary glomerulonephritis represents a secondary glomerular disease process (associated with autoimmune disease, infection or malignancy) in many cases and hence screening is essential. As the screening for comorbidities increased over time, more underlying causes were identified. We noted a high frequency of HCV among black patients, suggesting a possible causative association. Treatment of underlying disease is essential for patients for the best outcome.

Avascular necrosis

2013 ◽  
pp. 1266-1273
Author(s):  
Stefan Rehart ◽  
Martina Henniger
Keyword(s):  
Avascular Necrosis ◽  
Femoral Condyle ◽  
Clinical Signs ◽  
Disease Process ◽  
Core Decompression ◽  
Underlying Disease ◽  
Classification Systems ◽  
Circulatory Disorder ◽  
Ischaemic Necrosis ◽  
Important Disease

Avascular necrosis (AVN) represents an important disease process of the cartilage-bone complex, which can occur at any age. According to aetiology one may discriminate between rare idiopathic avascular necroses and more common forms that occur as an effect of the underlying disease or rather the therapy, the secondary avascular necroses. Pathophysiologically it is assumed that a circulatory disorder leads to an ischaemic necrosis of bone, bone marrow, and adjunct cartilage. Sites of the human skeleton with predilection to AVN are the femoral head, humeral head, femoral condyle, proximal tibia, and ossicles of the foot and hand. Clinical signs are unspecific, but in the region of the load-bearing lower extremities pain occurs usually early. Plain radiographs, MRI, and sometimes also skeletal scintigraphy are used for diagnosis and staging. Usually 4-5 stages are distinguished; there are extra classification systems for individual entities. Spontaneous healing in terms of a return to normal without further damage can be found in small, circumscribed areas, but the bigger and the nearer the joint the more unlikely this is. Depending on region, stage of disease, age of the patient, concomitant diseases and cause, several conservative and surgical therapies may be applied. Conservative treatments include exoneration and relief of the extremity, physiotherapy, and if necessary medical treatment. The need for surgical intervention becomes more likely as AVN increases in size and gets closer to the joint. Surgical therapies include core decompression, revascularizing techniques, vascular bone transplant, corrective/transposition osteotomy, arthrodesis/joint reinforcement, or joint replacement.

Ultrastructural application of the patsc-GMS staining in various kidney diseases

1993 ◽  
Vol 51 ◽  
pp. 308-309
Author(s):  
Shigeki Namimatsu ◽  
Shin-ichi Nakamura ◽  
Yoshizo Nakagami ◽  
Tatsuo Oguro ◽  
Goro Asano
Keyword(s):  
Kidney Diseases ◽  
Periodic Acid ◽  
Membranous Glomerulonephritis ◽  
Human Kidney ◽  
Renal Diseases ◽  
Ammonia Water ◽  
Transmission Electron ◽  
Ultrathin Sections ◽  
Methenamine Silver ◽  
Grid Mesh

We have previously reported a new staining method, PATSC-GMS, for transmission electron microscopy. In the present study, we evaluated the stainability and usefulness of the PATSC-GMS method in tissues from renal diseases.Fifty human kidney biopsies comprising normal (n=2), membranous glomerulonephritis (n=10), Alport's syndrome (n=l), IgA nephropathy (n=4), and other cases (n=33) were studied. Samples were pre-fixed in 2.5% glutaraldehyde, post-fixed in 1% osmium tetroxide, and embedded in Epok-812 after dehydration. Ultrathin sections were made and placed on nickel grid mesh. The sections of the tissues were Pre-incubated in ammonia water(25%) for 10minutes, oxidized in 1% periodic acid for 20 minutes, reacted in 0.1% thiosemicarbazid (TSC) for lminute, post-incubated in ammonia water(25%) for 5minutes and stained with gelatin methenamine silver(GMS) solution: (50ml of 3% methenamine, 5ml of 2% gelatin, 5ml of 5% silver nitrate, 40ml of distilled water, and 5-6ml of 5% sodium tetraborate) was performed for 50C 50minutes in the oven.

scholarly journals Targeted broad-based genetic testing by next-generation sequencing informs diagnosis and facilitates management in patients with kidney diseases

2019 ◽  
Author(s):  
M Adela Mansilla ◽  
Ramakrishna R Sompallae ◽  
Carla J Nishimura ◽  
Anne E Kwitek ◽  
Mycah J Kimble ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Clinical Diagnosis ◽  
Kidney Diseases ◽  
Genetic Diagnosis ◽  
Copy Number Variant ◽  
Underlying Disease ◽  
Renal Diseases ◽  
Single Nucleotide Variants ◽  
Glomerular Diseases ◽  
Pathogenic Variants

Abstract Background The clinical diagnosis of genetic renal diseases may be limited by the overlapping spectrum of manifestations between diseases or by the advancement of disease where clues to the original process are absent. The objective of this study was to determine whether genetic testing informs diagnosis and facilitates management of kidney disease patients. Methods We developed a comprehensive genetic testing panel (KidneySeq) to evaluate patients with various phenotypes including cystic diseases, congenital anomalies of the kidney and urinary tract (CAKUT), tubulointerstitial diseases, transport disorders and glomerular diseases. We evaluated this panel in 127 consecutive patients ranging in age from newborns to 81 years who had samples sent in for genetic testing. Results The performance of the sequencing pipeline for single-nucleotide variants was validated using CEPH (Centre de’Etude du Polymorphism) controls and for indels using Genome-in-a-Bottle. To test the reliability of the copy number variant (CNV) analysis, positive samples were re-sequenced and analyzed. For patient samples, a multidisciplinary review board interpreted genetic results in the context of clinical data. A genetic diagnosis was made in 54 (43%) patients and ranged from 54% for CAKUT, 53% for ciliopathies/tubulointerstitial diseases, 45% for transport disorders to 33% for glomerulopathies. Pathogenic and likely pathogenic variants included 46% missense, 11% nonsense, 6% splice site variants, 23% insertion–deletions and 14% CNVs. In 13 cases, the genetic result changed the clinical diagnosis. Conclusion Broad genetic testing should be considered in the evaluation of renal patients as it complements other tests and provides insight into the underlying disease and its management.

Laboratory Diagnostics in Septic Disseminated Intravascular Coagulation

2009 ◽  
Vol 03 (01) ◽  
pp. 19
Author(s):  
Giuseppe Lippi ◽  
Gian Cesare Guidi ◽  
◽  
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Coagulation Factors ◽  
Underlying Disease ◽  
Laboratory Diagnostics ◽  
Diagnostic Efficiency ◽  
Intravascular Coagulation ◽  
Diagnostic Algorithms ◽  
Clinical Signs And Symptoms

The diagnosis of septic disseminated intravascular coagulation (DIC) relies on clinical signs and symptoms, identification of the underlying disease and results of laboratory testing. Since no single test result alone can definitely establish or rule out the diagnosis, the laboratory diagnostics of septic DIC encompass a combination of tests for which simple diagnostic algorithms are now available. Global tests of haemostasis provide evidence of activation of blood coagulation and, ultimately, consumption of coagulation factors, but their diagnostic efficiency is as yet questionable. Fibrinolytic markers, namely D-dimer, reflect the extent of activation of both coagulation and fibrinolysis, so a normal value can be used in a ruling-out strategy. Decreased levels of the natural inhibitors are frequently observed in patients with septic DIC, but antithrombin and protein C measurements are not incorporated in any of the widely used diagnostic algorithms. Among the inflammatory biomarkers, procalcitonin is currently regarded as the gold standard to differentiate the type of infection and guide antibiotic therapy, but its clinical usefulness in identifying and predicting the outcome of patients with septic DIC is still circumstantial.

Bilateral jugular foraminal stenosis in a patient with benign osteopetrosis associated with pseudotumor cerebri syndrome

2009 ◽  
Vol 110 (4) ◽  
pp. 804-807 ◽  
Author(s):  
Sayed Mohammad Haji Mirsadeghi ◽  
Ali Tayebi Meybodi ◽  
Farideh Nejat ◽  
Hooshang Saberi
Keyword(s):  
Disease Process ◽  
Signs And Symptoms ◽  
Pseudotumor Cerebri ◽  
Underlying Disease ◽  
Foraminal Stenosis ◽  
Laboratory Studies ◽  
Venous Outflow ◽  
Shunt Insertion ◽  
Pseudotumor Cerebri Syndrome ◽  
The Brain

One of the prominent causes of pseudotumor cerebri (PTC) syndrome is increased impedance of the venous outflow tracts of the brain. Theoretically, this is a justified mechanism for raised intracranial pressure; yet, there had been few cases of such a scenario reported in the literature, and to the authors' knowledge no case of PTC due to benign osteopetrosis has been reported to date. The present case occurred in a 19-year-old woman with a constellation of signs and symptoms compatible with PTC syndrome, whose radiological and laboratory studies confirmed the diagnosis of osteopetrosis. Magnetic resonance venography demonstrated bilateral jugular foraminal stenosis regarding the underlying disease process. The patient did well after she underwent a lumboperitoneal shunt insertion procedure.

Clinical Signs, Clinicopathological Findings, Etiology, and Outcome Associated With Hemoptysis in Dogs: 36 Cases (1990–1999)

2002 ◽  
Vol 38 (2) ◽  
pp. 125-133 ◽  
Author(s):  
Nathan L. Bailiff ◽  
Carol R. Norris
Keyword(s):  
Heart Failure ◽  
Clinical Signs ◽  
Disease Process ◽  
Underlying Disease ◽  
Initial Visit ◽  
Lung Lobe ◽  
Immune Mediated ◽  
Clinicopathological Findings ◽  
Heartworm Disease ◽  
Underlying Diseases

Hemoptysis, the expectoration of blood or bloody mucus from the respiratory tract at or below the larynx, was retrospectively evaluated in 36 dogs. Cough, tachypnea, and dyspnea were common historical and physical examination signs. Anemia was documented in 11 dogs, but was severe in only one dog. Other clinicopathological findings reflected the underlying diseases. All thoracic radiographs obtained were abnormal; alveolar and interstitial patterns were most common. Diseases predisposing to hemoptysis included bacterial bronchopneumonia (n=7), neoplasia (n=5), trauma (n=5), immune-mediated thrombocytopenia (n=4), heartworm disease (n=4), rodenticide poisoning (n=3), lung-lobe torsion (n=1), left-sided congestive heart failure (n=1), pulmonary hypertension (n=1), and foreign-body pneumonia (n=1). Four additional dogs had more than one underlying disease process. Nine dogs were either euthanized or died in the hospital during the initial visit. While at least half of the 27 dogs discharged went on to completely recover, five dogs discharged were known to have either died or been euthanized as a result of their disease in <6 months.

Kawasaki disease—sudden death as the first presenting symptom

1992 ◽  
Vol 2 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Louis Tsun-cheung Chow ◽  
Wing-hing Chow ◽  
Christopher Chun-hing Tse ◽  
Eric Hon-man Wong ◽  
Koon-sang Wong ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Sudden Death ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Underlying Disease ◽  
Postmortem Examination ◽  
Arterial Aneurysm ◽  
True Nature ◽  
Clinical Signs And Symptoms ◽  
High Index Of Suspicion

SummaryTwo patients are described with sudden death as the first presenting symptom of Kawasaki disease. The first patient died of cardiac tamponade as a result of rupture of a coronary arterial aneurysm at the age of three months and nineteen days. The second patient, one and half years old, developed acute myocardial infarction secondary to coronary arterial aneurysm and thrombosis. The true nature of their underlying disease was realized only after postmortem examination. Their clinical signs and symptoms of Kawasaki disease might be so mild as to escape recognition. A high index of suspicion should be exercised by the clinician in order not to miss this condition, especially in places where Kawasaki disease is uncommon.

scholarly journals Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran

2016 ◽  
Vol 7 (04) ◽  
pp. 554-558 ◽  
Author(s):  
Samira Yadegari ◽  
Askar Ghorbani ◽  
S Roohollah Miri ◽  
Mohammad Abdollahi ◽  
Mohsen Rostami
Keyword(s):  
Risk Factors ◽  
Magnetic Resonance ◽  
Clinical Features ◽  
Sinus Thrombosis ◽  
Oral Contraceptive Pill ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Underlying Disease ◽  
Tertiary Referral Hospital ◽  
D Dimer

ABSTRACT Introduction: Despite increasing the use of magnetic resonance imaging (MRI), cerebral venous sinus thrombosis (CVST) has remained an under-diagnosed condition. In this study, characteristics and frequency of various risk factors of CVST patients in a tertiary referral hospital were closely assessed. Methods: Patients with an unequivocal diagnosis of CVST confirmed by MRI and magnetic resonance venography during 6 years of the study were included. All data from the onset of symptoms regarding clinical signs and symptoms, hospital admission, seasonal distribution, medical and drug history, thrombophilic profile, D-dimer, neuroimaging, cerebrospinal fluid findings, mortality, and outcome were collected and closely analyzed. Result: A total of 53 patients with female to male ratio of 3.07 and mean age of 33.7 years were included in the study. Headache and papilledema were the most frequent clinical features (44 and 36 patients, respectively). An underlying disease (diagnosed previously or after admission) was the most common identified risk factor for CVST in both females and males (21 patients). A total of 15 women used the oral contraceptive pill (OCP) where 12 of them had simultaneously other predisposing factors. Overall, 19 patients (36%) had more than one contributing factor. D-dimer had a sensitivity of 71.4% in CVST patients. The mortality of patients in this study was 3.7% (n = 2). Focal neurologic deficit and multicranial nerve palsy were associated with poor outcome which defined as death, recurrence, and massive intracranial hemorrhage due to anticoagulation (P = 0.050 and 0.004, respectively). Conclusion: Unlike most of the CVST studies in which OCP was the main factor; in this study, an underlying disease was the most identified cause. Considering the high probability of multiple risk factors in CVST that was shown by this study, appropriate work up should be noted to uncover them.

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