Miller M, Gooden M, Shah D, Soyibo A K, Williams J, Barton E N
Department of Obstetrics, Gynaecology and Child Health, The University of the West Indies, Kingston 7, Jamaica, West Indies.
West Indian Med J. 2010 Jun;59(3):325-9.
To document the histological findings in Jamaican children undergoing renal biopsy in order to determine the relative prevalence of varying types of glomerular disease in the island.
This study analyses retrospectively the renal histology in all Jamaican children less than age 12 years undergoing their first adequate renal biopsy between January 1985 and December 2008. Clinicopathological data were obtained solely from the histology reports from the University Hospital of the West Indies where all paediatric renal biopsies are processed.
Of the 270 children, aged 1 month to 11 years (mean 7.58 years), 147 [58.1%] were males. The commonest indications for renal biopsy were nephrotic syndrome (57.4%) and glomerulonephritis (30%). Most biopsied children (260/270) had glomerular disease. The predominant glomerulonephritides were diffuse proliferative glomerulonephritis (DPGN) (27.7%) and mesangial proliferative glomerulonephritis (MesGN) (25.5%). Glomerular disease was idiopathic in 136/260 (53%) but was infection-associated in 32.3% (84 cases) of which Poststreptococcal glomerulonephritis (PSGN) was the commonest (75%)--predominantly DPGN (74.6%). Hepatitis B followed at 15.5% (13/84) manifested as membranous nephropathy in 83.3% (10/12). In patients with SS disease, DPGN was the commonest histology (47.4%). Systemic lupus erythematosus accounted for 5% of all renal biopsies. Over time, PSGN occurred less frequently, with a parallel reduction in DPGN and MesGN.
In Jamaican children, DPGN is the commonest nephritis. Membranous nephropathy is primarily due to Hepatitis B. The commonest histology in SS disease is DPGN. The role of infection in the pathogenesis of renal disease in Jamaican children is probably underestimated.
记录接受肾活检的牙买加儿童的组织学检查结果，以确定该岛不同类型肾小球疾病的相对患病率。
本研究回顾性分析了1985年1月至2008年12月期间所有接受首次充分肾活检的12岁以下牙买加儿童的肾脏组织学情况。临床病理数据仅来自西印度大学医院的组织学报告，所有儿科肾活检均在此进行处理。
在270名年龄为1个月至11岁（平均7.58岁）的儿童中，147名（58.1%）为男性。肾活检最常见的指征是肾病综合征（57.4%）和肾小球肾炎（30%）。大多数接受活检的儿童（260/270）患有肾小球疾病。主要的肾小球肾炎类型为弥漫性增殖性肾小球肾炎（DPGN）（27.7%）和系膜增殖性肾小球肾炎（MesGN）（25.5%）。260例肾小球疾病中，136例（53%）为特发性，但32.3%（84例）与感染相关，其中链球菌感染后肾小球肾炎（PSGN）最为常见（75%），主要为DPGN（74.6%）。乙型肝炎占15.5%（13/84），83.3%（10/12）表现为膜性肾病。在镰状细胞病（SS病）患者中，DPGN是最常见的组织学类型（47.4%）。系统性红斑狼疮占所有肾活检的5%。随着时间的推移，PSGN的发生频率降低，DPGN和MesGN也相应减少。
在牙买加儿童中，DPGN是最常见的肾炎类型。膜性肾病主要由乙型肝炎引起。SS病最常见的组织学类型是DPGN。感染在牙买加儿童肾病发病机制中的作用可能被低估了。
