Clinicopathological study of nephrotic syndrome in Indian children :A tertiary care experience

  • Chetan Sudhakar Chaudhari Assistant Professor,Dept of Pathology LTMMC & LTMGH,Sion,Mumbai
  • Nitin M Gadgil
  • Prashant V Kumavat
  • Ganesh R Kshirsagar
  • Sagar Dhamne
Keywords: Paediatric, Nephrotic Syndrome, Electron Microscopy, Immunofluoresence

Abstract

Background: Nephrotic syndrome is an important chronic disorder in children with clinical manifestation of different histopathological subtypes. An aim of the study was to determine incidence of renal biopsy in paediatric nephrotic syndrome, correlations between the clinical and histomorphological patterns in Indian ethnicity children at our tertiary care institute.Methods: : A retrospective study of kidney biopsies with, immunofluorescence and electron microscopy with clinical outcome of the children with nephrotic syndrome was done over a period of 15 years. Biopsies were stained with Hematoxylin & eosin, Periodic acid Schiff and silver impregnation stain and also processed for immunofluorescence and electron microscopy as necessary. All renal biopsy findings were correlated with clinical response to steroid therapy, immunosuppressant, and clinical parameters.Result: Frequencies in results were calculated by Chi square test for categorical variables. Mann-Whitney U test was used for non parametric variables. Predominantly cases were seen in the age group 8-12 years. Atypical nephrotic syndrome was the commonest presenting feature followed by steroid resistant nephrotic syndrome. Minimal change disease was the commonest histomorphological pattern followed by focal segmental glomerular sclerosis. All the cases of membranous glomerulonephritis in study were secondary in nature. Light microscopy findings correlated with electron microscopy, in 80.95% cases.Conclusion: Minimal change disease occurs up to 6 times more commonly in Indian children than in Europian counterpart, but rise in FSGS cases as a cause for nephrotic syndrome is now being encountered. In India the proportion of cases with Membrano-proliferative glomerulonephritis is high, attributable to the high prevalence of infectious diseases like tuberculosis, chronic suppurative infections and malnutrition. DOI: 10.21276/apalm.2017.995

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Published
2017-02-03
Section
Original Article