Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1976 May;29(5):380–397. doi: 10.1136/jcp.29.5.380

Diseases and histological normality of the renal glomerulus: a clinicopathological study.

W Lawler, P Tarpey, G Williams, E J Acheson, N P Mallick
PMCID: PMC476075  PMID: 132460

Abstract

Thirty-seven percutaneous renal biopsies showing no significant abnormalities on light microscopy were studied electron optically and by immunofluorescence when available. Assessment of the pathological material was followed by analysis of the patients' clinical notes, and a clinicopathological correlation was carried out. Twenty-three patients fulfilled the clinical criteria of minimal change disease; 10 did not behave clinically as minimal change and showed immune complex deposition; two had benign recurrent haematuria; and two had myelomatosis. Our study shows that if diagnosis is based solely on the light microscope appearances of renal biopsy, diseases other than minimal change are likely to be overlooked. Accuracy of diagnosis in structural terms requires additional immunofluorescence and electron microscopic study; final clinical diagnosis also requires careful follow-up, and repeat biopsy may be necessary.

Full text

PDF
380

Images in this article

381Image
on p.381
382Image
on p.382
383Image
on p.383
384Image
on p.384
385Image
on p.385
386Image
on p.386
387Image
on p.387
388Image
on p.388
389Image
on p.389
389Image
on p.389
392Image
on p.392
393Image
on p.393
394Image
on p.394

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AYOUB E. M., VERNIER R. L. BENIGN RECURRENT HEMATURIA. Am J Dis Child. 1965 Mar;109:217–223. doi: 10.1001/archpedi.1965.02090020219004. [DOI] [PubMed] [Google Scholar]
  2. Abramowicz M., Barnett H. L., Edelmann C. M., Jr, Greifer I., Kobayashi O., Arneil G. C., Barron B. A., Gordillo-P G., Hallman N., Tiddens H. A. Controlled trial of azathioprine in children with nephrotic syndrome. A report for the international study of kidney disease in children. Lancet. 1970 May 9;1(7654):959–961. doi: 10.1016/s0140-6736(70)91093-7. [DOI] [PubMed] [Google Scholar]
  3. BENCOSME S. A., BERGMAN B. J. The ultrastructure of human and experimental glomerular lesions. Int Rev Exp Pathol. 1962;1:139–208. [PubMed] [Google Scholar]
  4. Berger J., Yaneva H., Hinglais N. Immunohistochemistry of glomerulonephritis. Adv Nephrol Necker Hosp. 1971;1:11–30. [PubMed] [Google Scholar]
  5. Bodian M., Black J. A., Kobayashi N., Lake B. D., Shuler S. E. Recurrent haematuria in childhood. Q J Med. 1965 Oct;34(136):359–382. [PubMed] [Google Scholar]
  6. Cameron J. S. Nephrotic syndrome. Br Med J. 1970 Nov 7;4(5731):350–353. doi: 10.1136/bmj.4.5731.350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cameron J. S., Turner D. R., Ogg C. S., Sharpstone P., Brown C. B. The nephrotic syndrome in adults with 'minimal change' glomerular lesions. Q J Med. 1974 Jul;43(171):461–488. [PubMed] [Google Scholar]
  8. Churg J., Habib R., White R. H. Pathology of the nephrotic syndrome in children: a report for the International Study of Kidney Disease in Children. Lancet. 1970 Jun 20;760(1):1299–1302. doi: 10.1016/s0140-6736(70)91905-7. [DOI] [PubMed] [Google Scholar]
  9. Drummond K. N., Michael A. F., Good R. A., Vernier R. L. The nephrotic syndrome of childhood: immunologic, clinical, and pathologic correlations. J Clin Invest. 1966 Apr;45(4):620–630. doi: 10.1172/JCI105376. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. FARQUHAR M. G., VERNIER R. L., GOOD R. A. An electron microscope study of the glomerulus in nephrosis, glomerulonephritis, and lupus erythematosus. J Exp Med. 1957 Nov 1;106(5):649–660. doi: 10.1084/jem.106.5.649. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. FARQUHAR M. G., VERNIER R. L., GOOD R. A. Studies on familial nephrosis. II. Glomerular changes observed with the electron microscope. Am J Pathol. 1957 Jul-Aug;33(4):791–817. [PMC free article] [PubMed] [Google Scholar]
  12. FOLLI G., POLLAK V. E., REID R. T., PIRANI C. L., KARK R. M. Electron-microscopic studies of reversible glomerular lesions in the adult nephrotic syndrome. Ann Intern Med. 1958 Oct;49(4):775–795. doi: 10.7326/0003-4819-49-4-775. [DOI] [PubMed] [Google Scholar]
  13. Ferris T. F., Gorden P., Kashgarian M., Epstein F. H. Recurrent hematuria and focal nephritis. N Engl J Med. 1967 Apr 6;276(14):770–775. doi: 10.1056/NEJM196704062761402. [DOI] [PubMed] [Google Scholar]
  14. Habib R., Kleinknecht C. The primary nephrotic syndrome of childhood. Classification and clinicopathologic study of 406 cases. Pathol Annu. 1971;6:417–474. [PubMed] [Google Scholar]
  15. Hopper J., Jr, Ryan P., Lee J. C., Rosenau W. Lipoid nephrosis in 31 adult patients: renal biopsy study by light, electron, and fluorescence microscopy with experience in treatment. Medicine (Baltimore) 1970 Jul;49(4):321–341. [PubMed] [Google Scholar]
  16. Hoyer J. R., Vernier R. L., Najarian J. S., Raij L., Simmons R. L., Michael A. F. Recurrence of idiopathic nephrotic syndrome after renal transplantation. Lancet. 1972 Aug 19;2(7773):343–348. doi: 10.1016/s0140-6736(72)91734-5. [DOI] [PubMed] [Google Scholar]
  17. Hyman L. R., Burkholder P. M. Focal sclerosing glomerulonephropathy with hyalinosis. A clinical and pathologic analysis of the disease in children. J Pediatr. 1974 Feb;84(2):217–225. doi: 10.1016/s0022-3476(74)80605-0. [DOI] [PubMed] [Google Scholar]
  18. Jenis E. H., Teichman S., Briggs W. A., Sandler P., Hollerman C. E., Calcagno P. L., Knieser M. R., Jensen G. E., Valeski J. E. Focal segmental glomerulosclerosis. Am J Med. 1974 Nov;57(5):695–705. doi: 10.1016/0002-9343(74)90843-2. [DOI] [PubMed] [Google Scholar]
  19. Lewis E. J., Kallen R. J. Glomerular localisation of IgE in lipoid nephrosis. Lancet. 1973 Jun 16;1(7816):1395–1395. doi: 10.1016/s0140-6736(73)91729-7. [DOI] [PubMed] [Google Scholar]
  20. MICHAEL A. F., DRUMMOND K. N., VERNIER R. L., GOOD R. A. IMMUNOLOGIC BASIS OF RENAL DISEASE. Pediatr Clin North Am. 1964 Aug;11:685–721. doi: 10.1016/s0031-3955(16)31590-5. [DOI] [PubMed] [Google Scholar]
  21. MOVAT H. Z., McGREGOR D. D. The fine structure of the glomerulus in membranous glomerulonephritis (lipoid nephrosis) in adults. Am J Clin Pathol. 1959 Aug;32(2):109–127. doi: 10.1093/ajcp/32.2.109. [DOI] [PubMed] [Google Scholar]
  22. Morel-Maroger L., Leathem A., Richet G. Glomerular abnormalities in nonsystemic diseases. Relationship between findings by light microscopy and immunofluorescence in 433 renal biopsy specimens. Am J Med. 1972 Aug;53(2):170–184. doi: 10.1016/0002-9343(72)90127-1. [DOI] [PubMed] [Google Scholar]
  23. Nagi A. H., Alexander F., Lannigan R. Light and electron microscopical studies of focal glomerular sclerosis. J Clin Pathol. 1971 Dec;24(9):846–850. doi: 10.1136/jcp.24.9.846. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Pollak V. E., Rosen S., Pirani C. L., Muehrcke R. C., Kark R. M. Natural history of lipoid nephrosis and of membranous glomerulonephritis. Ann Intern Med. 1968 Dec;69(6):1171–1196. doi: 10.7326/0003-4819-69-6-1171. [DOI] [PubMed] [Google Scholar]
  25. Singer D. B., Hill L. L., Rosenberg H. S., Marshall J., Swenson R. Recurrent hematuria in childhood. N Engl J Med. 1968 Jul 4;279(1):7–12. doi: 10.1056/NEJM196807042790102. [DOI] [PubMed] [Google Scholar]
  26. White R. H., Glasgow E. F., Mills R. J. Clinicopathological study of nephrotic syndrome in childhood. Lancet. 1970 Jun 27;1(7661):1353–1359. doi: 10.1016/s0140-6736(70)91268-7. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES