Role of special stains as a useful complementary tool in the diagnosis of renal diseases: a case series study

Authors

  • Veenaa Venkatesh Department of Pathology, Karpagam Faculty of Medical Science and Research, Coimbatore, India
  • Vinuta Malaichamy Department of Pathology, Coimbatore Medical College, Coimbatore, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20191632

Keywords:

Renal diseases, Special stains

Abstract

Background: Renal diseases constitute a major cause of morbidity in clinical practice and their incidence is on rise. Investigation usually requires division into even smaller samples to permit the application of specialized techniques.

Methods: This is a prospective study conducted over a period of one year from January 2018 to December 2018 in the Department of Pathology, Coimbatore. A total of 58 renal biopsies were received from the Nephrology Department and the tissues were subjected to light microscopic and special stain studies.

Results: Total 53 patients (91.38%) had high blood urea nitrogen value more than 20.0 mg/dl. 48 patients (82.76%) had high serum creatinine value more than 1.2 mg/dl. Out of 58 biopsy specimens, 46 (79.31%) showed primary glomerular lesions, 10 (17.24%) showed secondary glomerular lesion and 2 (3.45%) showed tubulointerstitial nephritis. Jones’s methanamine silver stain along with PAS stain helped in typing/staging of membranous glomerulopathy and membranoproliferative glomerulonephritis. Various changes in GBM like spike formation, thickening and moth-eaten appearance of GBM was noted which is seen in MGN stage II, IV and III respectively. Double contour and thickening of GBM was noted which is seen in type I and II MPGN respectively. In Myeloma cast nephropathy, tubular casts stained negative with Congo red which was used to differentiate it from amyloid deposition.

Conclusions: The special stains used in this study helped in supplementing the light microscopic findings for diagnosis of kidney lesions. However, the use of other ancillary techniques like immunofluorescence and electron microscopy would help the pathologists in better and more accurate diagnosis.

References

Agarwal SK, Sethi S, Dinda AK. Basics of kidney biopsy: A nephrologist's perspective. Indian J Nephrol. 2013;23(4):243-52.

Alwall, N. Aspiration biopsy of the kidney, including report of a case of amyloidosis diagnosed in 1944 and investigated at autopsy. Acta Med Scand. 1952;143:430-5.

Iversen P, Brun C. Aspiration biopsy of the kidney. Am J Med. 1951;11:324-30.

Kark RM, Muehrcke RC. Biopsy of kidney in prone position. Lancet. 1954;266:1047-9.

Cameron S, Hicks J. The introduction of renal biopsy into nephrology from 1901 to 1961: a paradigm of the forming of nephrology by technology. Am J Nephrol. 1997;17(3-4):347-58.

Fuiano G, Mazza G, Comi N, Caglioti A, De Nicola L, Iodice C, et al. Current indications for renal biopsy: a questionnaire-based survey. Am J Kidney Dis. 2000;35(3):448-57.

Walker PD, Cavallo T, Bonsib SM. Practice guidelines for the renal biopsy. Modern Pathol. 2004;17(12):1555.

Hoffmann EO. High-resolution light microscopy for interpretation of renal biopsies. Pediatr Nephrol. 1995;9:763-9.

Simon P, Ramee MP, Boulahrouz R, Stanescu C, Charasse C, Seng aNG KI, et al. Epidemiologic data of primary glomerular diseases in western France. Kidney Int. 2004;66(3):905-8.

Okpechi I, Swanepoel C, Duffield M, Mahala B, Wearne N, Alagbe S, et al. Patterns of renal disease in Cape Town South Africa: a 10-year review of a single-centre renal biopsy database. Nephrol Dialysis Transplant. 2010;26(6):1853-61.

Alwahaibi NY, Alhabsi TA, Alrawahi SA. Pattern of glomerular diseases in Oman: A study based on light microscopy and immunofluorescence. Saudi J Kidney Dis Transplant. 2013;24(2):387.

Deshpande GU, Munjal R, Rai R. Spectrum of nephropathies with special reference to primary glomerulopathies. Med J Armed Forces India. 2000;56(2):125-9.

Rychlı´K I, JancˇOva´ E, Tesarˇ VR, Kolsky´ A, La´Cha J, StejskalJ, et al. The Czech Registry of Renal Biopsies. Occurrence of Renal Diseases in The Years 1994-2000. Nephrol Dial Transplant. 2004;19:3040-9.

Malafronte P, Mastroianni-Kirsztajn G, Gustavo N. Nico B, ´Dio Roma˜O J, Almerinda MR. et al. Paulista Registry of Glomerulonephritis: 5-Year Data Report. Nephrol Dial Transplant. 2006;21:3098-105.

Andreucci VE, Fuiano G, Stanziale P, Andreucci M. Role of renal biopsy in the diagnosis and prognosis of acute renal failure. Kidney Int. 1998 (Suppl 1);66:S91-5.

Amann K. New parameters in kidney biopsy diagnostic-morphometry. Kidney Blood Pressure Res. 2000;23(3-5):181.

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Published

2019-04-26

How to Cite

Venkatesh, V., & Malaichamy, V. (2019). Role of special stains as a useful complementary tool in the diagnosis of renal diseases: a case series study. International Journal of Research in Medical Sciences, 7(5), 1539–1545. https://doi.org/10.18203/2320-6012.ijrms20191632

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Original Research Articles