Co-existence of thin basement membrane nephropathy with other glomerular pathologies; a single center experience

The co-existence of thin basement membrane nephropathy [TBMN] and another glomerular pathology portends a worse prognosis than TBMN alone. The purpose of our study was to investigate the prevalence of TBMN and associated glomerular pathologies at our institution. We reviewed all renal biopsies performed at Saint Louis University hospital over a 7-year period. We excluded all post transplant biopsies, and biopsies showing diabetic glomerulopathy, membranoproliferative glomerulopathy, membranous glomerulopathy, and biopsies where no electron microscopy or immunofluorescent studies were done. All other biopsies were included. A total of 634 biopsies were included in the study. The prevalence of TBMN was 47 [7.4%], of whom 17 [36.2%] had TBMN alone. In the remaining 30 [63.8%] patients TBMN was associated with other glomerular pathologies: IgAN 9 [19.1%] and FSGS 9 [19.1%]. We found significantly higher prevalence of IgAN in patients with TBMN versus all biopsies [19.1% vs. 7.7%, respectively, P = 0.002]. We found significant similarities in biopsy indications for TBMN and IgAN group. Around two thirds of the cases of TBMN were associated with other glomerular pathologies. The prevalence of IgAN, but not focal segmental glomerulosclerosis, was significantly higher in patients with TBMN as compared to the general renal biopsy specimens

review on hydatid cyst of liver, with a brief report of 126 cases from Fars province

A retrospective review of 126 surgically-proven cases of hydatid cyst of the liver was performed. Sixty percent of the patients were in the third and fourth decades of life. The most common presenting complaint was right upper abdominal pain and/or fullness sensation [92%]. Duration of symptoms was more than two months in 61%. One third of the patients had more than one cyst in the liver. Cysts were located in the right lobe in 68%, left lobe in 19% and both lobes in 13%. In 6%, other intra abdominal cysts were found during surgery. Cysts were infected in 29% and were complicated by rupture or fistula formation in 10%. Chest x-rays were abnormal in 37% [elevated right hemidiaphragm, 22%; right lower lobe infiltrate/atelectasis, 5%; right pleural effusion, 13%; pulmonary hydatid cyst, 7%]. Plain abdominal films were abnormal in 41% [curvilinear calcification, 22.5%; hepatomegaly, 24%; splenomegaly, 5%; air fluid level in the liver cyst, 2.5%]. Upper gastrointestinal barium studies showed extrinsic pressure on the stomach and duodenum in 40%. Liver scintigraphy was abnormal in 96%, but in 25% there was a discrepancy either in number or location of the cyst[s] when compared to surgical findings. Angiography was abnormal in all the cases performed. Literature on pathophysiology, radiologic findings [including CT scan and ultrasonography], and on surgical and medical therapy of hydatid disease of the liver is reviewed