Cara-Fuentes et al., "Case series: CTLA4-IgG1 therapy in minimal change disease
and focal segmental glomerulosclerosis," Pediatric Nephrology, vol.
Abbreviations CTL: Cytotoxic T lymphocyte GFR: Glomerular filtration rate IFN: Interferon MCD: Minimal change disease
MDRD: Modified diet in renal disease MAIT: Mucosal-associated invariant T NK: Natural killer NKT: Natural killer T SGH: Singapore General Hospital Teff: Effector T Th: T helper Treg: Regulatory T.
Patients who had a renal histology of either minimal change disease
, idiopathic mesangial proliferation, or focal and segmental glomerulosclerosis were treated with oral cyclophosphamide (CYC) prescribed at a dose of 3 mg/Kg/day for 8 weeks along with 60 mg/[m.sup.2] of alternate day steroids.
Audit of renal biopsies at JPMC Karachi has shown that focal segmental glome- rulosclerosis is the most frequently occurring entity followed by membranous glomerulonephritis and min- imal change disease.10 Muzaffar et al has reported that membranoproliferative GN is the leading cause of glo- merulopathy followed by minimal change disease
and focal segmental glomerulosclerosis which is modera- tely in agreement with the finding of this series.11Our study revealed high occurrence of biopsy pro- ven renal amyloidosis.
Urinary levels of CD80 in patients with relapsed minimal change disease
were significantly greater when compared to those in patients with minimal change disease
in remission, SLE (with and without proteinuria), other glomerulopathies (FSGS, membranoproliferative glomerulonephritis, IgA nephropathy, and membranous nephropathy), and healthy control patients .
Fifty-five of the biopsies showed minimal change disease
(MCD), the hisological finding suggestive of minimal change nephrotic syndrome; 43 showed mesangial hypercellulatriy (MH); and 72 revealed focal and segmental glomerulosclerosis (FSGS).
GN: Glomerulonephritis, TIN: Tubulo Interstitial Nephritis, MCD: Minimal Change Disease
, MPGN: Membrano Proliferative Glomerulonephritis
Minimal Change Disease
. Minimal change disease
(MCD) accounts for 10-15% of patients with idiopathic nephrotic syndrome in adults .
Over all in this study, the commonest subtype of adult nephrotic syndrome was found to be Focal Segmental Glomerulosclerosis (45%) followed by Membranous Nephropathy (30%), Membrano Proliferative Glomerulonephritis (16%) Minimal Change Disease
(5%) and IgA Nephropathy (4%) respectively.
The spectrum of pathological lesions in the adult nephrotic population was wide and comprised focal and segmental glomerulosclerosis (39.87%), followed by membranous nephropathy (26.58%), minimal change disease
(14.82%), mesangiocapillary glomerulonephritis (4.3%), mesangio-proliferative glomerulonephritis (4.11%), post-infectious glomerulonephritis (2.84%), IgA nephropathy (2.53%), and other rare lesions8.
The list of primary and secondary glomerulonephritis (GN) is long and commonly includes diseases like minimal change disease
(MCD), membranous GN, FSGS, diffuse endocapillary (post infectious) GN, IgAN, diabetic nephropathy and lupus nephritis.2 These diseases present as one of the following clinical syndromes: nephritic syndrome, nephrotic syndrome(NS), non-nephrotic proteinuria, isolated haematuria and acute or chronic renal failure.3,4 The purpose of this study was to highlight the importance of IF in accurately diagnosing various types of GN.
Primary glomerular disease is largely idiopathic in origin and includes minimal change disease
, Berger disease (immunoglobulin A [IgA] nephropathy), and focal and segmental glomerular sclerosis (Brady & Brenner, 2001; Brady, O'Meara, & Brenner, 2001).