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塌陷性肾小球病:一项为期七年的单中心临床病理研究

Collapsing Glomerulopathy: A Single Centre Clinicopathologic Study of Seven Years.

作者信息

Kanodia Kamal V, Vanikar Aruna V, Patel Rashmi D, Suthar Kamlesh S, Nigam Lovelesh K, Patel Himanshu V, Kute Vivek, Trivedi Hargovind L

机构信息

Professor, Department of Pathology, Lab Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India .

Professor and Head, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India .

出版信息

J Clin Diagn Res. 2016 Apr;10(4):EC15-7. doi: 10.7860/JCDR/2016/17297.7646. Epub 2016 Apr 1.

Abstract

INTRODUCTION

Collapsing Glomerulopathy (CG) is recognized as distinct pattern of proliferative parenchymal injury with poor response to empirical therapy.

AIM

A single center retrospective study was carried out to find out clinicopathological features of idiopathic CG.

MATERIALS AND METHODS

A total of 3335 native renal biopsies were analyzed retrospectively which were performed from 2008 to 2014 with emphasis on clinicopathological correlation and histopathological presentation.

RESULTS

Idiopathic CG constituted 0.75% incidence (25 out of 3335 biopsies) of all biopsies, adults constituting major study part with 88%. The duration of the symptoms at the time of biopsy was 34.12±26.09 days and 35±22.91 days respectively in adults and children. Hypertension was noted in 9(40.9%) and oliguria in 8(36.4%) in adults. Urinalysis revealed microscopic haematuria 12(54.5%) in adults. Nephrotic range proteinuria was reported in 10 (45.5%) adult patients. Glomerular collapse with hyperplasia/ hypertrophy of podocytes was seen in 4.54±3.11 glomeruli. Tubular microcystic dilation was seen in 16(64%) patients. Tubular atrophy involving mild (t1) in 15(60%), moderate (t2) in 4(16%) and severe (t3) in 6(24%) patients. Interstitial fibrosis was mild (i1) in 17(68%), moderate (i2) in 2(8%) and severe (i3) in 6(24%) patients.

CONCLUSION

Idiopathic CG is a morphological pattern of grave podocyte injury with poor prognosis. However, there are chances of remission/ recovery if the tubular atrophy and interstitial fibrosis are of grades ≤ t1 i1.

摘要

引言

塌陷性肾小球病(CG)被认为是一种增殖性实质损伤的独特模式,对经验性治疗反应不佳。

目的

进行一项单中心回顾性研究,以找出特发性CG的临床病理特征。

材料与方法

回顾性分析了2008年至2014年期间共3335例肾活检标本,重点关注临床病理相关性和组织病理学表现。

结果

特发性CG占所有活检病例的0.75%(3335例活检中有25例),其中成年人占主要研究部分,为88%。成人和儿童活检时症状持续时间分别为34.12±26.09天和35±22.91天。成人中9例(40.9%)有高血压,8例(36.4%)有少尿。尿液分析显示成人中有12例(54.5%)镜下血尿。10例(45.5%)成年患者出现肾病范围蛋白尿。在4.54±3.11个肾小球中可见肾小球塌陷伴足细胞增生/肥大。16例(64%)患者出现肾小管微囊性扩张。15例(60%)患者肾小管萎缩为轻度(t1),4例(16%)为中度(t2),6例(24%)为重度(t3)。17例(68%)患者间质纤维化轻度(i1),2例(8%)为中度(i2),6例(24%)为重度(i3)。

结论

特发性CG是一种严重的足细胞损伤形态模式,预后不良。然而,如果肾小管萎缩和间质纤维化程度≤t1 i1,则有缓解/恢复的机会。

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