An Unusual Complication of Mesenteric-Portal Axis Thrombosis and Septic Shock in a Patient with Mesangial Proliferative Glomerulonephritis

Twenty one cases of hepatoesplenic schistosomiasis patients without clinical and laboratory evidence of renal disease, were studied by surgical biopsies using light microscopy and immunofluorescence. The cases were classified histologically as: normal pattern (6 cases); minimal changes (6 cases); and mesangial proliferative glomerulonephritis (9 cases). By the immunofluorescence microscopy using anti IgM, IgG, IgA and C3, the predominant finding in all biopsies, except the normal cases, was granular deposits of IgM in the mesangium along with C3. On the other hand, IgG was present in all cases including normal biopsies along the capillary walls. However IgG was also present in the mesangium only in cases with glomerular lesions. This finding may well be similar to that recently described as IgM mesangial nephropathy. According to our cases a mesangial proliferative glomerulonephritis, characterized by segmental cell proliferation and deposition of IgM in the mesangium, is probably the entity found in the early stages of mansonic schistosomiasis.

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Kidney Biopsy: An Experience from Tertiary Hospital

Journal of Nepal Medical Association ◽

10.31729/jnma.2192 ◽

2014 ◽

Vol 52 (193) ◽

pp. 707-712 ◽

Cited By ~ 1

Author(s):

Madhav Ghimire ◽

Bishnu Pahari ◽

Navaraj Paudel ◽

Gayatri Das ◽

Gopal Chandra Das ◽

...

Keyword(s):

Kidney Biopsy ◽

Tertiary Hospital ◽

Proliferative Glomerulonephritis ◽

Safe Procedure ◽

Mesangial Proliferative Glomerulonephritis ◽

Macroscopic Hematuria ◽

Histological Pattern ◽

Renal Histology ◽

Perinephric Hematoma ◽

Nephrotic Range Proteinuria

Introduction: Kidney Biopsy is an important diagnostic tool in Nephrology. It is useful in Nephrology in terms of diagnosis, prognosis and management. There is little information on renal biopsy data from central Nepal. We describe our center`s experience in kidney biopsy in term of histological patterns, complications and outcomes.Methods: We prospectively analyzed the biopsies data of patients over a period of one and half year. All kinds of kidney disease patients were included for kidney biopsy, irrespective of their clinical syndromes and underlying diagnosis.Results: A total of 75 biopsies were analyzed. Majority of them were females; 56% (n=42). Most of the biopsies; 84% (n=63) were from younger subjects ≤ 45 years and majority of them fell in the age group 11-20 years. Most common clinical renal syndrome to undergo biopsy was Sub Nephrotic range Proteinuria in 53.3% (n=40). Among comorbid conditions, 53.3% (n=40) had Hypertension. The most common histological pattern seen was Mesangial proliferative Glomerulonephritis (MesPGN) seen in 24% (n=18). Among complications associated with the procedure, macroscopic hematuria was seen in 6.7% (n=5) cases and clinically significant perinephric hematoma causing pain was seen in 5.3% (n=4). There was no mortality associated with biopsy procedure.Conclusions: Sub Nephrotic range Proteinuria was the commonest clinical renal Syndrome observed. In terms of renal histology, Mesangial Proliferative Glomerulonephritis (MesPGN) was the commonest histological pattern observed. Kidney biopsy is a safe procedure without any significant adverse events.Keywords: Kidney biopsy, sub nephrotic range proteinuria, mesangial proliferative glomerulonephritis

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