The Value of Electron Microscopy in the Diagnosis of Membranoproliferative Glomerulonephritis Accompanied by Laboratory and Clinical Findings

membranoproliferative glomerulonephritis (MPGN) is one of the most common primary glomerulonephritis which can affect kidneys and lead to end-stage renal disease. The aim of this study is to provide clinical and paraclinical information of patients that MPGN was proved for them by Electron microscope (EM) and to focus on the value of the EM in the diagnosis of all types of the diseases.Materials and Methods In this cross-sectional study, we investigated kidney biopsies which were sent to the referral electron microscope unit (affiliated to the medical school of Shiraz University of Medical Sciences) from 2001 to 2016. The final diagnosis of MPGN was based on the EM study. For each patient, primary light microscopy(LM) finding was compared with EM diagnosis. The available patients’ demographic, clinical and paraclinical data were extracted from the pathology request sheet. All the statistical analysis was performed in SPSS 19.0 and independent T-test, chi-square or Fisher’s exact test was used, and p<0.05 was considered as statistically significant. Results:151 patients diagnosed with MPGN including 142 (94.0%) patients as type one, 7 (4.6%) patients as type two, and 2(1.3%) patients as type three were enrolled in the current study.EM was essential for the diagnosis of MPGN in 42.4% of biopsies. It was also helpful in 9.9% of cases and non- necessary for the diagnosis of 47.7% of patients. In immunofluorescence (IF) study, the most common immunoglobulin was IgG (53.8%) followed by IgM and IgA. There were also 7 cases C3 positive. Mean age of patients was 31.9±18 with the approximately equal proportion between males and females. The most prevalent clinical manifestation of patients was proteinuria, hematuria, and edema. Hematuria significantly had more prevalence in children. Mean arterial blood pressure of patients, regardless of their age and sex was 97.2±14.5. in our study, 23.8% of patients had hypertension which was significantly more common in adults Conclusion:EM study has a notable role in the diagnosis of different types of MPGN. Considering the limitations of using EM, the results obtained from this study can help with the appropriate use of it. Also, it helps physicians for a certain and earlier diagnosis.

Keywords:

Microscopy , Electron , Transmission , light microscopy , membranoproliferative glomerulonephritis , Kidney.