Pathology Department, Grande International Hospital, Kathmandu, Nepal.
PLoS One. 2022 Oct 27;17(10):e0276172. doi: 10.1371/journal.pone.0276172. eCollection 2022.
Glomerular diseases are important causes of morbidity and mortality among children in developing countries. Renal biopsy is the gold standard for determining histological diagnosis, prognosis, and therapy options. This study aimed to investigate the clinical, histopathological, and direct immunofluorescence findings of renal biopsy results in Nepalese children under 18 years old.
In this retrospective cross-sectional study, the available data from children who had undergone kidney biopsy between 2016 and the end of 2020 were evaluated. Demographic data, indications of biopsy, histopathologic findings, and direct immunofluorescence findings were collected and presented.
The mean age of the patients was 12.14 ± 4.07 years. Male/female ratio was 1:1. The majority of biopsy cases were aged between 11-15 years of age. The most common indication for biopsy in children was nephrotic syndrome (68.25%). Lupus nephritis with 28 cases (22.22%) had the highest frequency in overall renal biopsies. Minimal change disease (MCD) with 22 cases (17.46%) followed by Ig A nephropathy with 16 cases (12.69%) were the most frequent primary glomerulonephritis. Lupus nephritis showed full house positivity, and MCD showed full house negativity in all Direct immunofluorescence (DIF) parameters, whereas immunoglobulin A nephropathy showed 100% positivity in Ig A in DIF.
Nephrotic syndrome was the most common indication for renal biopsy. The most common primary glomerulonephritis was MCD, while secondary glomerulonephritis was lupus nephritis. Clinical data, light microscopy, and direct DIF played an integral role in the overall final diagnosis.
肾小球疾病是发展中国家儿童发病率和死亡率的重要原因。肾活检是确定组织学诊断、预后和治疗选择的金标准。本研究旨在探讨尼泊尔 18 岁以下儿童肾活检结果的临床、组织病理学和直接免疫荧光检查结果。
在这项回顾性横断面研究中，评估了 2016 年至 2020 年底期间进行肾活检的儿童的可用数据。收集并呈现了人口统计学数据、活检指征、组织病理学发现和直接免疫荧光发现。
患者的平均年龄为 12.14±4.07 岁。男/女比例为 1:1。大多数活检病例的年龄在 11-15 岁之间。儿童活检最常见的指征是肾病综合征（68.25%）。狼疮性肾炎 28 例（22.22%）在所有肾活检中频率最高。微小病变性肾病（MCD）22 例（17.46%），其次是 IgA 肾病 16 例（12.69%），是最常见的原发性肾小球肾炎。狼疮性肾炎在所有直接免疫荧光（DIF）参数中均表现为全屋阳性，MCD 则表现为全屋阴性，而 IgA 肾病在 DIF 中表现为 100%阳性。
肾病综合征是肾活检最常见的指征。最常见的原发性肾小球肾炎是 MCD，而继发性肾小球肾炎是狼疮性肾炎。临床资料、光镜和直接 DIF 在总体最终诊断中发挥了重要作用。
