Comparative Changes Noted in Renal Biopsies on Light Microscopy of ANCA Positive Vs ANCA Negative Serology
Correspondence Address :
Dr. Rahul Mannan,
B-61, First Floor Flat Ranjit Avenue, Amritsar-143001, Punjab, India.
E-mail : rahulmannan@gmail.com
Objectives: Pauci-immune glomerulonephritis is the commonest cause of rapidly progressive glomerulonephritis (RPGN) which is associated with increased mortality and morbidity. More than 90% of these patients have serological presence of either antineutrophil cytoplasmic antibodies (ANCA), of cytoplamic (C) or perinuclear (P) type. “Immunofluoresence studies” exhibiting minimal or no fluorescence is diagnostic in all such cases. The present study aims to study the differences between renal biopsies of serologically ANCA negative versus ANCA positive individuals.
Materials and Methods: One hundred and twenty renal biopsies (of clinically suspected cases of systemic vasculitis) were sub-divided sub-divided under the heading of serologically ANCA positive and serologically ANCA negative; and scoring them by means of a semi-quantitative scoring system devised at the beginning of the study to identify statistically significant, specific light microscopic features in the sub-components of renal biopsy.
Results: Fifteen parameters were found to be statistically significantly (p-value < 0.05) in ANCA positive serological cases. These were glomerular capillary loop infiltration by neutrophils, cellular crescents, fibro-cellular crescents, glomerular fibrinoid necrosis, glomerular sclerosis, peri-glomerular infiltration, interstitial oedema, interstitial eosinophils, tubular atrophy, tubular necrosis, tubulitis, arterial hyalinization, arterial necrosis, arterial vessel wall polymorpho nuclear infiltrate and myointimal hypertrophy.
Conclusion: The presence of above parameters in a renal biopsy report of a patient (in absence of facilities of autoimmune serology and immunofluoresence) can alert both nephrologist and nephropathologist to keep a possibility of renal symptoms arising out of systemic vasculitis.
Acute renal failure, Pauci-immune glomerulonephritis, Vasculitis
DOI: 10.7860/JCDR/2015/12330.5785
Date of Submission: Nov 28, 2014
Date of Peer Review: Feb 18, 2015
Date of Acceptance: Mar 07, 2015
Date of Publishing: Apr 01, 2015
Financial OR OTHER COMPETING INTERESTS: None.
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com