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Focal Segmental Glomerulosclerosis as the Leading Cause of Idiopathic Nephrotic Syndrome: A different spectrum revealed by mandatory renal biopsy in all patients

Authors:

Swarnali Mani Joardar ,

College of Medicine and Sagore Dutta Hospital, India, IN
About Swarnali
College of Medicine and Sagore Dutta Hospital, India
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Rita Chatterjee,

Medical College, Kolkata, IN
About Rita
Medical College, Kolkata, India
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Shubhadeep Das,

Medical College, Kolkata, IN
About Shubhadeep
Medical College, Kolkata, India
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Siddhartha Mani

Medical College, Kolkata, IN
About Siddhartha
Medical College, Kolkata, India
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Abstract

Introduction: Idiopathic nephrotic syndrome (INS) is associated with varied glomerular lesions. The evidence so far confirms a higher incidence of minimal change disease (MCD) than other subtypes in children. Different newer trials and review literatures suggest a 2-fold increase in the incidence of focal segmental glomerulosclerosis (FSGS) in recent decades.

Objective: To determine the histopathology of idiopathic nephrotic syndrome following mandatory renal biopsy

Method: The patients attending the Department of Paediatric Medicine with a diagnosis of INS were selected for the study. A confirmatory diagnosis was established. Thereafter all patients underwent a mandatory renal biopsy (after exclusion of any absolute contraindication) and histopathology examination. Different findings were compared between MCD and Non-MCD groups (those having histological lesion other than MCD).

Results: There were 52 children suffering from nephrotic syndrome (NS) whom we included in our study. The most frequently noted glomerular lesion was FSGS in 45% followed by MCD in 27%, mesangioproliferative glomerulonephritis (MSGN), membranoproliferative glomerulonephritis (MPGN) and membranous glomerulonephritis (MGN). The incidence of relapse was significantly higher in the Non-MCD group (p=0.02).

Conclusions: In our study, a mandatory renal biopsy in all patients found FSGS to be the most common glomerular lesion among paediatric age group patients suffering from INS.

(Key Words: Focal segmental glomerulosclerosis, idiopathic nephrotic syndrome, renal biopsy)

DOI: http://dx.doi.org/10.4038/sljch.v45i2.7979

How to Cite: Joardar, S.M., Chatterjee, R., Das, S. and Mani, S., 2016. Focal Segmental Glomerulosclerosis as the Leading Cause of Idiopathic Nephrotic Syndrome: A different spectrum revealed by mandatory renal biopsy in all patients. Sri Lanka Journal of Child Health, 45(2), pp.76–83. DOI: http://doi.org/10.4038/sljch.v45i2.7979
Published on 06 Jun 2016.
Peer Reviewed

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