02373nas a2200229   4500000000100000008004100001260001600042100002000058700001400078700001200092700001200104700001200116700001100128700001100139700001200150700001200162245011300174300001000287490000700297520182500304022001402129       2018                            d  c-60943780311 aRamachandran R.1 aSakhuja V1 aKohli H1 aGupta K1 aRathi M1 aNada R1 aJha V.1 aKumar V1 aMuthu V00aClinicopathological Spectrum of Glomerular Diseases in Adolescents: A Single-center Experience over 4 Years.  a15-200 v283 a<p>
The spectrum of biopsy-proven glomerular disease was studied from a single center in Northwestern India, among adolescents aged 13-19 years. From January 2009 to December 2012, a total of 177 patients with biopsy-proven glomerular disease were studied. The same pathologist reported all the biopsy specimens after subjecting to light, immunofluorescence, and electron microscopy. The clinical profile and laboratory findings of the patients were correlated with the histopathological spectrum of glomerular diseases. Males formed 71.19% ( = 126) and the remaining 28.81% ( = 51) were females. Lupus nephritis had a strong female predominance, whereas minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) had a male predominance. Nephrotic syndrome was the indication for biopsy in 65% of the cases. Rapidly progressive renal failure and acute nephritis were the next common indications accounting for 14% and 7%, respectively. FSGS was the most common glomerular disease in adolescents ( = 45, 25.4%). The next common were MCD and lupus nephritis each contributing 21.6% and 10.7%, respectively. Primary glomerular diseases accounted for 84.75% ( = 150) of the total. The remaining 15.25% ( = 27) were attributed to secondary glomerular diseases, of which lupus nephritis was the most common, i.e., in 70.4% patients ( = 19). FSGS was the most common histology in adolescent nephrotic participants (37%). MCD was the next common, found in 31% of nephrotic patients. Electron microscopy changed the diagnosis made by light microscopy and immunofluorescence in 5.6% cases only, and it confirmed the diagnosis in another 21.6%. Kidney biopsy in adolescents is a safe procedure. The spectrum of glomerular diseases in adolescents is different from that seen in adults and smaller children.
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