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2015 ; 16
(ä): 213
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Trends in the histopathology of childhood nephrotic syndrome in Ibadan Nigeria:
preponderance of idiopathic focal segmental glomerulosclerosis
#MMPMID26670137
Asinobi AO
; Ademola AD
; Okolo CA
; Yaria JO
BMC Nephrol
2015[Dec]; 16
(ä): 213
PMID26670137
show ga
BACKGROUND: Reports on the histopathology of childhood nephrotic syndrome (NS)
had emanated from our Centre since the 1960s and by the late 1980s and early
1990s, a change was observed and reported. Taking into consideration the
worldwide changing trend in the histopathology of the NS and our Unit policy
change in the indications for renal biopsy, a change was envisaged. We therefore
evaluated the current histologic pattern of childhood NS in Ibadan with the view
to highlighting any variations from the past and comparing the findings with
regional and global trends. METHODOLOGY: We reviewed our database and analyzed
the renal biopsy findings in patients who were biopsied before treatment was
administered between 1997 and 2001 and those with mostly idiopathic steroid
resistant NS (SRNS) and secondary NS, managed between 2006 and 2013. A
comparative analysis of the findings from the present study was carried out with
two previous reports from our Unit in the 1970s and early 1990s and also with
reports from other Centres. RESULTS: A total of 78 patients had successful
biopsies done during the study period in children aged between 2 ½ and 16 years.
In both pre-treatment biopsy era (1997-2001) and post-treatment biopsy era
(2006-2013), focal segmental glomerulosclerosis (FSGS) predominated. 75 % of the
patients had idiopathic NS and among the patients that had idiopathic steroid
resistant NS, FSGS was the most common followed by MPGN. For secondary NS, MCD
was the most common but could be the early stages of either membranous
nephropathy (MN) or FSGS. Chronic pyelonephritis and chronic interstitial
nephritis occurred in 25 % of the study population but they were more prevalent
in secondary nephrotic syndrome. CONCLUSION: FSGS is the most common
histopathology in children requiring renal biopsy in Ibadan presently. FSGS is
also the most common histopathology in idiopathic SRNS, which is in keeping with
reports from most parts of the world. There has been a transition from the
preponderance of Quartan Malarial Nephropathy (QMN) in the 1960s to MPGN in the
1980s to FSGS presently. This has great implications with regards to searching
for new aetiologic factors, providing more efficacious treatment modalities and
ensuring facilities for immunofluorescence, electron microscopic and genetic
studies.