Mitra Mehrazama; Nakysa Hooman; Alireza Abdollahi; Hasan Otukesh
Volume 2, Issue 3 , June 2007, , Pages 109-114
Abstract
Background and objective: Hemolytic uremic syndrome (HUS) is the most prevalent cause of children renal insufficiency which in many cases (90%) occurs following diarrhea. Hemolytic microangiopathic anemia, thrombocytopenia, and renal insufficiency are main symptoms of hemolytic uremic syndrome. This ...
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Background and objective: Hemolytic uremic syndrome (HUS) is the most prevalent cause of children renal insufficiency which in many cases (90%) occurs following diarrhea. Hemolytic microangiopathic anemia, thrombocytopenia, and renal insufficiency are main symptoms of hemolytic uremic syndrome. This study aims to consider the relationship between pathologic data of nephro-biopsy and laboratory data of children suffering from the disease. Material and Methods: This study has been carried out in retrospective, cross-sectional and descriptive procedures. For this purpose, 28 patients with an average age of 6 years suffering from uremic hemolytic syndrome referred to Ali Asghar Hospital over the last 10 years. Light microscopic data of glomeruli, arterioles, arteries, interstitial tissue, medullary vessels and tubules were evaluated. Laboratory data including hematology, biochemistry, and urinary tests were extracted from patients’ files. Data were analyzed using SPSS software. Results: The most prevalent damages in glomeruli were decreased capillary lumen and thickening of its wall and in arterioles were mild decrease of lumen and in artery thickening of intima and mild infiltration of inflammatory cells and mild edema in interstitial and hyperemia in vaso recta and the most prevalent pathology in tubules was the existence of cast. Significant relationship was found out between time of recovery of hematological disorders and medullary vessels congestion and reduplication of arterial inner elastic lamina and also improvement of biochemistry changes with glomerulus necrosis and leucocytes assembly in vaso recta. Arteriolar rate with creatinine serum level at discharge time was related and tubular rate with platelet count at discharging time was also related. Conclusion: Biopsy is an important tool for prognosis and det ermination of disease intensity. There was valuable statistical relationship between some laboratory data at the time of referral and pathological data which even could influence intensity or prognosis of disease.
Nakysa Hooman; Seyed Taher Esfehani; Abas Madani; Esfandiar Bodagi; Parvin Mohseni
Volume 1, Issue 2 , April 2006, , Pages 69-74
Abstract
Background and Objectives: This research study was conducted to determine the correlation between the clinicopathologic features and the outcome of membranous nephropathy. Materials and Methods: Data were retrospectively reviewed from all patients with a diagnosis of membranous nephropathy. Demographic, ...
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Background and Objectives: This research study was conducted to determine the correlation between the clinicopathologic features and the outcome of membranous nephropathy. Materials and Methods: Data were retrospectively reviewed from all patients with a diagnosis of membranous nephropathy. Demographic, initial laboratory, and clinical findings were collected and the biopsy specimens were reviewed to classify them. To compare means, frequency, and to find correlation, student t-test, non-parametric x2 and Kendall-tau statistical tests were used respectively. A p value less than 0.05 were considered significant. Results: It was found out that during the years 1972-1996, 72 out of 2118 kidney biopsies had been diagnosed as membranous nephropathy. In this respect, male/female ratio was 2:1 (with a range of 1.5-14 years). Meanwhile, 45 out of 72 cases were idiopathic membranous nephropathy (IMN). Furthermore, 27 out of 72 had a secondary cause of the disease due to systemic lupus erythematosus (11 cases) and HBsAg positive (12 patients). The most common features in both groups were nephrotic syndrome and hematuria. In idiopathic and in chronic renal failure groups, remission occurred in 20.9% and 20.9 % of the cases respectively during an averaged 2.13 years of follow up. The statistical test Kendall-tau was used to determine the correlation between initial findings and outcome in IMN. In this regard, a significant direct correlation was found between progression to renal failure and proteinuria (p = 0.009) and/or age (p = 0.01) at the time of admission. For secondary membranous nephropathy, the outcomes were variable depending on the etiology.Conclusion: Proteinuria, age, and underlying etiology are the most important factors determining the renal outcome in membranous nephropathy.