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A Clinicopathological Study on Renal Biopsies in Children.

Journal of the Korean Pediatric Society 1985;28(7):705-713.
Published online July 31, 1985.
A Clinicopathological Study on Renal Biopsies in Children.
Chung Hye Chu, Byoung Soo Cho, Chang Il Ahn
Department of Pediatrics, School of Medicin,Kyung Hee University
소아 신생검 환아의 임상 및 병리학적 고찰
주정혜, 조병수, 안창일
경희대학교 의과대학 소아과학교실
Abstract
A clinical and histopathological study was made on 53 cases of ultrasonoguided renal biopsies in children who were admitted to pediatric ward of Kyung Hee University Hospital, from February 1, 1979 to March 31, 1984. The result were as follows: 1)The final diagnosis was confirmed by ultrasonoguided renal biopsy in this 53 cases and there was no severe complication (perirenal hematoma, renal laceration, renal abscess, spleen rupture, sepsis) except transient hematuria. Consequently ultrasonoguided percutaneous renal biopsy can be recognized as the most useful method for the safe and accurate diagno stic evaluation of patients. 2) Among 53 cases, 39 cases were male and 14 cases female. The sex ratio of male to female was 2.8 : 1. The age distribution was from 1 1/2 months to 15 years of age, and the most prevalent age group was 7~9 years. 3)The Clinical classifications of the 53 cases of renal biopsies in children were nephrotic syndrome 46 cases(86.8%), acute glomerulonephritis 6 cases(11.3%) and miscellaneous 1 case (1.9%). 4)The lighit microscopic diagnosis of the 53 cases of renal biopsies in children were Minimal lesion 27 case3(50.9%), Focal and segmental glomerulosclerosis 5 cases(9.4%), Postinfectious glomerulonephritis 5 cases(9.4%), Henoch-schonlein purpura 4 cases(7.6%), Mesangial proliferative glomerulonephritis 3 cases(5.7%), Membranous glomerulopathy 3 cases(5.7%), embranoproliferative glomerulonephritis 1 case(1.9%). 5)Immunopathologic diagnosis correlated with light microscopic diagnosis of the 53 cases of renal biopsies in children were Minimal lesion 13 cases(24.5%), Focal and segmental glomerulosclerosis 6 cases(11.3%), Postinfectious glomerulonephritis 6 cases(11.3%)> IgM nephropathy 5 cases(9.4%), Henoch-Schonlein purpura 4 cases(7.5%) Membranous glomerulopathy 3 cases(5.7%), IgA nephropathy 3 cases(5.7%). 6)Light microscopic classifications of nephrotic syndrome were Minimal lesion 27 cases (58.7%), Focal and segmental glomerulosclerosis 5 cases(10.9%)> Purpura nephritis 4 cases (8.7%), Mesangial proliferative glomerulonephritis 3 cases(6.5%), Membranous glomerulopathy 3 cases(6.5%), Membranoproliferative glomerulonephritis 1 case(2.2%) Congenital nephrotic syndrome 1 case(2.2%), Systemic lupus erythematosus 1 case(2.2%) and Hemolyticuremic syndrome 1 case(2.2%). 7) Hematuria was observed in 28 cases(60.9%) with nephrotic syndrome and in 13 cases (48.1%) with Minimal lesion; it occurred in a higher proportion of patients with structural glomerular abnormalities. 8)Hypertension was observed in 12 cases(26.1%) with nephrotic syndrome and in 6 cases (22.2%) with Minimal lesion; it occurred in a slightly higher proportion of patients with structural glomerular abnormalities. 9)Massive proteinuria over 2.0 gm per day was observed in 29 cases(63.0%) with nephrotic syndrome and moderate proteinuria from 0.5 to 2.0 gm per day in 11 cases(23.9%) and mild proteinuria below 0.5 gm per day in 6 cases(13.1%).
Key Words: Renal diseases, Ultrasonogram raided renal biopsy, Nephrotic syndrome


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