Noor Khan Lakhnana, Farzana Khalid, Haroon Khan, Ghias Butt.
Morphology of Nephrotic Syndrome in Adults An experience at PIMS, Islamabad.
J Rawal Med Coll Jan ;5(2):84-8.

Background: A study to see the pattern of glomerular lesions in nephrotic syndrome in adults. Methods: A total of 91 cases of nephrotic syndrome, ranging in age from 16 to 70 years, were studied by correlating light microscopic and immunofluorescence findings. Results: Primary nephrotic syndrome was observed in 85 percent of cases while the remaining were of secondary nature. Membranoproliferative glomerulonephritis (GN) was the major cause, followed by membranous GN, mesangioproliferative GN and crescentic GN as cause of primary nephrotic syndrome in adults. Secondary nephrotic syndrome was mainly associated with lupus nephritis, renal amyloidosis and diabetic glomerulosclerosis. Findings of immunofluorescence microscopy usually substantiated the findings of optical microscopy. However, on occasions, they were more informative, e.g., in IgA nephropathy, and detection of two early cases of membranous nephropathy from minimal change disease. It also helped in differentiating the types of membranoproliferative glomerulonephritis. Conclusion: Nephrotic syndrome is a fairly common disorder and is primary in causation. In adults membranoproliferative GN is the most common entity responsible. In primary nephrotic syndrome, the patient age is usually between second and fourth decades, whereas in secondary nephrotic syndrome, it is fourth to fifth decade.

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