Department of Pathology, Post Graduate Institute of Medical Education and Research (PGIMER), Dr RML Hospital, New Delhi, India.
Department of Pathology, Post Graduate Institute of Medical Education and Research (PGIMER), Dr RML Hospital, New Delhi, India.
J Infect Public Health. 2018 Sep-Oct;11(5):732-734. doi: 10.1016/j.jiph.2018.05.004. Epub 2018 Jun 9.
Filariasis is traditionally diagnosed on finding microfilaria in peripheral blood smear and in cases of occult filariasis by immunological tests. Clinically, it presents with a wide range of symptoms and signs. We present two cases of filariasis presenting with renal symptoms warranting kidney biopsy. Histopathology of both revealed microfilaria in the glomerular capillary loop. First case was a 23-year-old male who presented with complaints of passage of milky urine. Second case was a 36-year-old female patient who presented with complaints of gross hematuria. Urine examination revealed nephrotic range proteinuria in both patients. Subsequently they underwent guided kidney biopsy for the evaluation of nephrotic range protienuria. Histopathology of both revealed microfilaria in the glomerular capillary loop. However, neither of the two cases showed proliferative changes in the glomeruli. To conclude, diagnosis of filariasis on kidney biopsy by identifying microfilaria is very rare. High index of suspicion is required to diagnose filariasis due to its wide range of clinical presentation and laboratory findings.
丝虫病传统上通过在外周血涂片上发现微丝蚴和在隐匿性丝虫病病例中通过免疫学检查来诊断。临床上，它表现出广泛的症状和体征。我们报告了两例以肾脏症状为表现需要进行肾活检的丝虫病病例。这两例的组织病理学均显示肾小球毛细血管袢中有微丝蚴。第一例是一名 23 岁男性，主诉出现乳白色尿液。第二例是一名 36 岁女性患者，主诉出现肉眼血尿。尿液检查显示两例患者均有肾病范围蛋白尿。随后，他们接受了引导性肾活检以评估肾病范围蛋白尿。这两例的组织病理学均显示肾小球毛细血管袢中有微丝蚴。然而，这两例均未显示肾小球的增生性改变。总之，通过识别微丝蚴在肾活检中诊断丝虫病非常罕见。由于其广泛的临床表现和实验室发现，需要高度怀疑才能诊断丝虫病。
