IgM nephropathy in adults: incidence and correlation with electron microscopic features.

IgM nephropathy is characterised on light microscopy (LM) by variable features of normal glomeruli to mesangial hypercellularity; and immunofluorescence (IF) deposits of LgM. Our aim was to study the incidence of IgM nephropathy in adults with primary glomerular disease, with correlation to electron microscopy (EM) features. All adults presenting with proteinuria glomerular hematuria underwent renal biopsy. We excluded patients with systemic diseases and post-infectious glomerulonephritis. All the specimens were evaluated by LM, IF and EM. Our series had 146 cases. Of the 42 cases diagnosed on LM as minimal change disease, mesangial deposition of IgM was present in 11 cases. In addition there were seven cases of mesangioproliferative glomerulonephritis with mesangial IgM deposition. Thus, there were a total of 18 cases of IgM nephropathy (12.3%). Only six of these 18 cases showed typical electron dense deposits in the mesangium on EM. We feel that IgM nephropathy is probably a separate pathological entity, comprising 12.3% of all adults with primary chronic glomerulopathy. Electron dense deposits are seen in only about a third of these cases.

Cancer and AIDS.

The occurrence of cancer as an AIDS defined disease is a subject that has received scant attention in the Indian medical establishments and lay public. It is important to know that the concept of acquired immunodeficiency syndrome was ushered in with reports of rare forms of cancers in HIV infected subjects. In the developed countries 34% of AIDS patients suffer from cancer, a cancer that is very aggressive, resistant to treatment and often fatal. On the other hand, incidence of cancer in patients infected with HIV virus is only 3%-4% in the Indian population. Nearly all patients with AIDS in India are victims of tuberculosis and opportunistic infections. Among the various cancers reported in the Indian population Kaposi's sarcoma is very rare indeed. AIDS associated malignant tumours tend to be more anaplastic and disseminate fairly early. The object of this review is to increase awareness of the various aspects of cancer and AIDS. There is an urgent need to improve gathering of epidemiological data and to direct research effort to explain a very strikingly low incidence of cancers in Indian subjects as compared to that in the West (prevalence of 4% versus 34% among HIV infected patients).