Date A, Dakshinamurthy D S, Jacob C K, Shastry J C
Christian Medical College and Hospital, Vellore, India.
J Clin Pathol. 1998 Apr;51(4):337-9. doi: 10.1136/jcp.51.4.337.
Delay in reporting the immunofluorescence findings on renal biopsies, owing to an interruption in supply of reagents, made possible a retrospective analysis of the effect of the lack of this information on patient management. Hospital case records of the 39 patients so affected were reviewed to determine what changes in their management took place after the immunofluorescence findings became available. The clinical, laboratory, and light microscopic findings in all except a case of pauci-immune crescentic glomerulonephritis allowed management decisions to be made that were not influenced by immunofluorescence findings. This was owing to correct prediction of the immunofluorescence findings, as in cases of IgA nephropathy presenting with recurrent haematuria; the adequacy of light microscopy in the interpretation of graft biopsies, in classifying lupus nephritis and in most cases of nephrotic syndrome; and the absence of entities identifiable only by immunofluorescence among these patients.
由于试剂供应中断，肾活检免疫荧光结果报告延迟，这使得对缺乏该信息对患者管理的影响进行回顾性分析成为可能。对受此影响的39例患者的医院病例记录进行了审查，以确定免疫荧光结果出来后他们的治疗发生了哪些变化。除了1例寡免疫性新月体性肾小球肾炎外，所有患者的临床、实验室和光镜检查结果都能使治疗决策不受免疫荧光结果的影响。这是因为免疫荧光结果能够被正确预测，如表现为复发性血尿的IgA肾病；光镜检查在移植肾活检解读、狼疮性肾炎分类以及大多数肾病综合征病例中足够充分；并且这些患者中不存在仅通过免疫荧光才能识别的疾病实体。
