Abstract:
Five hundred consecutive renal biopsies were examined at the
Department of pathology, Faculty of Medicine from January 1990 to November
1991. Two cores of renal tissue were obtained. One was fixed in 10% formal
saline for immunohistochemical studies.The other was fixed in DBS solution for
light microscopic studies. In a few selected cases 0.1 mm of renal tissue was fixed
in 4% gluteraldehyde for electron microscopic studies. Haematoxyline and cosin
H
E) ,PAS and silver methanamine stains were performed on all biomine stains were
performed on all biopsies.Immunohistochemistry was performed using IgG,
IgM,IgA, antisera. One hundred and forty three had nephritic syndrome, 55 had
features of nephritic/ nephritic syndrome, 26 had chronic renal failure and another
26 had acute renal failure. Seventeen transplant biopsies were included while 183
patients had persistant proteinuria or haematuria. Seventy four biopsies contained
less than five glomeruli and were considered not sufficient four accurate
diagnosis. Out of 426 biopsies 40% had minimal change, 13% had mesangial
proliferation, 6% had mesangio- capillary glomerulonephritis, 0.5% had
membranous glomerulonephritis, 8% had focal segmental glomerulosclerosis, 7.4
% had crescentic glomerulonephritis. 4.6% had extensive glomerulosclerosis,
10% were in the resolving stage of post-streptococcal glomeruhistological patterns
like diabetic nephritis and pyelonephritis. Imminoohistochemical studies showed
IgA immune complexes in 23 patients (5.6%). This study shows the histological
patterns of glomerulonephritis in Sri lanka. This is the first time IgA nephropathy
is documented in Sri Lanka
