Clinicopathological Features of primary nephrotic syndrome in Iraqi children
Dr. Monir Hamid Naif, Dr. Taghreed Fadhil Mohammed, Dr. Mohammad Ali Mohammad
Background: Nephrotic syndrome is clinical manifestation of different histopathological subtypes. Objective: To study the histopathological lesion in idiopathic childhood nephrotic syndrome based on renal biopsy, and to make clinic pathological correlation. Patients and Methods: The data were collected retrospectively from records of the pediatric nephrology units at central child teaching hospital and AL –Kathemia teaching hospital during the period from January 2005 to May 2012, involving one hundred four patients aged up to 18 years with nephrotic syndrome whom renal biopsy had been done for them. The following data were collected from the files; personal data (age, sex), presenting symptoms and signs, biochemical data (serum urea, creatinine, cholesterol), C3 level if indicated. Initial episode, relapse, predisposing factors, familial history of nephrotic syndrome, Treatment and complication. Result: percutaneous renal biopsies were done in one hundred four children –fifty six (54%) males and forty eight (46%) females, male to female ratio was 1.2:1 . age at onset range between o.8-15(median3.6) years . steroid sensitive patients were 58%, and 41.3% of them were steroid resistance . based on histological finding on renal biopsy, 39.4% were minimal change disease, 24.03 % were focal segmental, 16.3% were membranoproliferative glomerulonephritis. Other histological subtype were 10.6% mesangioprolefrative glomerulonephritis, 6.7% were global mesangial sclerosis, 0.96% were membranous nephropathy. Conclusion: This study gives a detailed information about the primary nephrotic syndrome in childhood. Minimal change disease was most common type followed by focal segmental glomerulosclerosis, but frequency of focal segmental glomerulosclerosis and to lesser extent the membranoproliferative glomerulonephritis had been increasing in Iraqi children with INS. clinical feature, age, sex and respond to steroid are similar to most parts of world.