A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal Amyloidosis
Background: Electron microscopy (EM) is a valuable tool in the diagnosis of renal amyloidosis, particularly in the early stages of the disease. In Iran, studies on EM and the clinical features of renal amyloidosis are scarce. The objective of the present study was to survey EM investigations, pathol...
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| Format: | Article |
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Shiraz University of Medical Sciences
2021-01-01
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| Series: | Iranian Journal of Medical Sciences |
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| Online Access: | https://ijms.sums.ac.ir/article_46894_45775a1c7da294b9d4dfe50e06039982.pdf |
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| author | Seyed Mohammad Owji Hadi Raeisi Shahraki Seyed Hossein Owji |
| author_facet | Seyed Mohammad Owji Hadi Raeisi Shahraki Seyed Hossein Owji |
| author_sort | Seyed Mohammad Owji |
| collection | DOAJ |
| description | Background: Electron microscopy (EM) is a valuable tool in the diagnosis of renal amyloidosis, particularly in the early stages of the disease. In Iran, studies on EM and the clinical features of renal amyloidosis are scarce. The objective of the present study was to survey EM investigations, pathological classifications, and clinical features of renal amyloidosis.Methods: This cross-sectional study was performed in Shiraz, Iran, during 2001-2016. Out of 2,770 kidney biopsies, 27 cases with a diagnosis of renal amyloidosis were investigated. EM investigation and six staining procedures for light microscopy (LM) were performed. Two pathological classifications based on glomerular, peritubular, perivascular, and interstitial involvement were made. Finally, the association between these classifications and the clinical features was assessed. Chi-square, Fisher’s exact, Independent t test, and Multiple logistic regression analysis were used. P values<0.05 were considered statistically significant.Results: In 51.9% of the cases, the clinical diagnosis was nephrotic syndrome. Proteinuria and edema were the most prevalent clinical manifestations. The role of EM investigation for diagnosis was graded “necessary” or “supportive” in 48.2% of the patients. In the classification based on glomerular classes, variables such as the mean blood pressure (P=0.003), history of hypertension (P=0.02), creatinine >1.5 (P=0.03), and severe tubular atrophy (P=0.03) were significantly higher in class B (advanced amyloid depositions).Conclusion: EM plays an important role in the diagnosis of renal amyloidosis. EM in conjunction with LM investigation with Congo red staining is recommended, to prevent misdiagnosis of patients with a clinical suspicion of renal amyloidosis. Among different pathological features of renal amyloidosis, the severity of glomerular amyloid depositions had a clear relationship with clinical presentations. |
| first_indexed | 2024-12-17T15:05:28Z |
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| issn | 0253-0716 1735-3688 |
| language | English |
| last_indexed | 2024-12-17T15:05:28Z |
| publishDate | 2021-01-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Medical Sciences |
| spelling | doaj.art-8ff16e45f8374c4b81b577e5630ecd5a2022-12-21T21:43:48ZengShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-07161735-36882021-01-01461324210.30476/ijms.2019.82110.46894A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal AmyloidosisSeyed Mohammad Owji0Hadi Raeisi Shahraki1Seyed Hossein Owji2Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, IranStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, IranBackground: Electron microscopy (EM) is a valuable tool in the diagnosis of renal amyloidosis, particularly in the early stages of the disease. In Iran, studies on EM and the clinical features of renal amyloidosis are scarce. The objective of the present study was to survey EM investigations, pathological classifications, and clinical features of renal amyloidosis.Methods: This cross-sectional study was performed in Shiraz, Iran, during 2001-2016. Out of 2,770 kidney biopsies, 27 cases with a diagnosis of renal amyloidosis were investigated. EM investigation and six staining procedures for light microscopy (LM) were performed. Two pathological classifications based on glomerular, peritubular, perivascular, and interstitial involvement were made. Finally, the association between these classifications and the clinical features was assessed. Chi-square, Fisher’s exact, Independent t test, and Multiple logistic regression analysis were used. P values<0.05 were considered statistically significant.Results: In 51.9% of the cases, the clinical diagnosis was nephrotic syndrome. Proteinuria and edema were the most prevalent clinical manifestations. The role of EM investigation for diagnosis was graded “necessary” or “supportive” in 48.2% of the patients. In the classification based on glomerular classes, variables such as the mean blood pressure (P=0.003), history of hypertension (P=0.02), creatinine >1.5 (P=0.03), and severe tubular atrophy (P=0.03) were significantly higher in class B (advanced amyloid depositions).Conclusion: EM plays an important role in the diagnosis of renal amyloidosis. EM in conjunction with LM investigation with Congo red staining is recommended, to prevent misdiagnosis of patients with a clinical suspicion of renal amyloidosis. Among different pathological features of renal amyloidosis, the severity of glomerular amyloid depositions had a clear relationship with clinical presentations.https://ijms.sums.ac.ir/article_46894_45775a1c7da294b9d4dfe50e06039982.pdfamyloidosismicroscopyelectronsproteinurianephrotic syndromekidney |
| spellingShingle | Seyed Mohammad Owji Hadi Raeisi Shahraki Seyed Hossein Owji A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal Amyloidosis Iranian Journal of Medical Sciences amyloidosis microscopy electrons proteinuria nephrotic syndrome kidney |
| title | A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal Amyloidosis |
| title_full | A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal Amyloidosis |
| title_fullStr | A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal Amyloidosis |
| title_full_unstemmed | A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal Amyloidosis |
| title_short | A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal Amyloidosis |
| title_sort | 16 year survey of clinicopathological findings electron microscopy and classification of renal amyloidosis |
| topic | amyloidosis microscopy electrons proteinuria nephrotic syndrome kidney |
| url | https://ijms.sums.ac.ir/article_46894_45775a1c7da294b9d4dfe50e06039982.pdf |
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