General Pathology Division, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil.
Ann Diagn Pathol. 2013 Feb;17(1):22-7. doi: 10.1016/j.anndiagpath.2012.04.006. Epub 2012 May 30.
Renal biopsy is an important method of diagnosis and prognosis in children and adolescents with renal diseases, and there are few studies describing the histopathologic alterations in renal biopsies in these age groups. The aim of this study was to evaluate the incidence of morphologic alterations described in renal biopsies carried out in children and adolescents. Patients aged between 1 month and 18 years were observed from 1996 to 2010 and were separated into 3 age groups: 0 to 6 (group 1, n = 29), 6 to 12 (group 2, n = 31), and 13 to 18 (group 3, n = 77) years. Morphologic alterations were evaluated according to light microscopy, immunofluorescence, and electron microscopy findings. The most common glomerulopathies observed in these different age groups were as follows: group 1-podocytopathy (34.78%), hereditary proteinurias 5 (21.73%), lupus nephritis (13.04%), and Berger disease (8.69%); group 2-podocytopathy (44.44%), acute diffuse glomerulonephritis (22.22%), Berger disease (11.11%), and Alport syndrome or thin membrane disease (11.11%); and group 3-lupus nephritis (22.85%), podocytopathy (20.00%), Berger disease (15.71%), and membranous glomerulopathies (11.42%). This study allows for better knowledge of the prevalence of nephropathies in children and adolescents and shows that a well-supported early diagnosis is indispensable for a more adequate treatment of patients with renal diseases.
肾活检是儿童和青少年肾脏疾病诊断和预后的重要方法,目前很少有研究描述这些年龄段肾活检的组织病理学改变。本研究旨在评估描述在儿童和青少年肾活检中出现的形态改变的发生率。1996 年至 2010 年观察了年龄在 1 个月至 18 岁的患者,并将其分为 3 个年龄组:0 至 6 岁(第 1 组,n = 29)、6 至 12 岁(第 2 组,n = 31)和 13 至 18 岁(第 3 组,n = 77)。根据光镜、免疫荧光和电镜检查结果评估形态改变。在这些不同年龄组中观察到的最常见肾小球病变如下:第 1 组-足细胞病(34.78%)、遗传性蛋白尿 5 型(21.73%)、狼疮性肾炎(13.04%)和 Berger 病(8.69%);第 2 组-足细胞病(44.44%)、急性弥漫性肾小球肾炎(22.22%)、Berger 病(11.11%)和 Alport 综合征或薄基底膜肾病(11.11%);第 3 组-狼疮性肾炎(22.85%)、足细胞病(20.00%)、Berger 病(15.71%)和膜性肾小球病(11.42%)。本研究使我们更好地了解儿童和青少年肾脏病的患病率,并表明早期诊断至关重要,有助于为肾脏疾病患者提供更适当的治疗。