ABSTRACT
BackgroundIgA nephropathy and MPGN are common glomerulonephritis in the world that progresses slowly andrenal function can even remain unchanged for decades. Clinically, it presents by isolated hematuria,proteinuria. Histologically, IgA nephropathy presents with acute glomerular damage, mesangial cellproliferation, endocapillary leucocyte infiltration, and crescent formations, these lesions can undergoresolution with sclerotic healing. Since 2013, renal biopsy has been done at the First Central Hospitalof Mongolia a few times. However, the confirmative diagnosis of IgA nephropathy and MPGN remainunknown in Mongolia by renal biopsy. Therefore, we intended to test renal biopsy techniques andconfirm its diagnosis by renal biopsy at the Second Central Hospital of Mongolia.MethodsUltrasound guided renal biopsy had been done for four patients by nephrologist at the Departmentof Nephrology of the Second Central Hospital of Mongolia. All four specimens were evaluated assatisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissuewas divided into two tips: one piece for routine H&E stain and special stains, including Masson’strichrome, and PAS stain; another piece for immunofluorescence by frozen section, which werestained with IgG, IgM, IgA and complement component 3 (C3). Each case was screened by threepathologists.Results:The case which shows mesengial widening, mesengial hypercellularity under the light microscopyor mesangial granular deposition of IgA and C3 by immunofluorescence was diagnosed as IgAnephropathy. We obtained crescent formation with glomerular adhesion in most cases. In addition, weobserved secondary MPGN in one case, which is caused by hepatitis C virus infection.Conclusion: Probably, it is a new step for developing pathologic diagnosis for nephrology in Mongolia.We needs further study for improving renal biopsy technique and confirming the diagnosis of IgAnephropathy and MPGN using electron microscopy and pathological report by oxford classification forIgA nephropathy.
ABSTRACT
Background: In recent years, kidney complication of diabetes became the basic cause of the end stage of renal disease in many countries around the world and then primary kidney disease goes on the 2-3 places. Due to the fact that diabetes mellitus turns more and more into non-communicable worldwide epidemic, we faced the increase in kidney complication which is one of form of micro vascular complications. So, illness of every 1-2 in three patients to undergo a renal replacement therapy has been diagnosed as diabetic nephropathy and of course nephrologists could not leave this fact without their attention. Goal: To study a change in the kidney structure with type 2 diabetic patients. Materials and Methods: Within the scope of the research 35 autopsied passed way because of the type 2 diabetes in clinical hospitals. According to Tervaert classification of diabetic kidney pathology issued by American Society of Nephrology in 2006, changes in glomerular structure were divided into 4 classes. Ordinary staining methods as hemotoxilin eosin, Van Gizonestaning connective tissue, Periodic Acid- Schiff standing have been used.Results: 35 autopsied in total, including 23 male (65.7%) and 12 female (34.3%) were covered by this research. And glomerular basement membrane thickening discovered in 51.4%, mesangial matrix expansion in 34.2%, Kimmelstiel-Wilson nodule in 20% and advanced glomerulosclerosis in 8.5% of total cases, respectively.Conclusions:1. It is found that diabetic kidney can be classified by Tervaert classification using ordinary standing and PAS reaction on the light microscope.2. However, we faced an essential necessity to be armed with immunofluorescence and electron microscope for the purpose to improve diagnostic examination and establish classes more accurately.3. Today when the medical science develops as evidence-based medicine, a starting the kidney biopsy samples assaying become the vital issue in comparative studying the clinical stage of diabetic kidney pathology.