Amal Abd El hafez

Abstract

Introduction: Glomerulonephropathies (GNs) have high burden of morbidity and mortality worldwide. The distribution GNs varies significantly due to several factors. Materials and Methods: This retrospective clinico-pathological study estimates the biopsy-proven distribution of primary and secondary GNs and detect s the predominant patterns among adult patients who underwent renal biopsy at Nephrology Centre, King Abdul-Aziz Specialist Hospital, Taif City, Kingdom of Saudi Arabia (KSA) from 2008 to 2013 with comparing data to other KSA studies and to other countries. Analysis of possible contributing factors for variation is provided. Relevant patients’ data were collected from hospital records. Renal biopsies stained with H&E, Periodic Acid Schiff (PAS), Gomori Methenamine Silver (GMS), Masson Trichrome (MT) and immunofluorescence (IF) were examined and categorized according to the World Health Organization (WHO) classification of glomerular diseases. Comparisons to other studies were set. Results: Primary and secondary GNs comprised 59.4% and 40.6%. Focal segmental glomerulosclerosis (FSGS) was the commonest primary GN (29.3%), followed by minimal change disease (MCD, 22%) then membranous glomerulonephropathy (MGN, 19.5%). IgA nephropathy was the least frequent (IgAN, 2.4%). Lupus nephritis (LN) was the commonest secondary GN (75%), followed by diabetic and vascular nephropathies (DN, 17.9% ; VN, 7.1%). Spatial and temporal variations in GNs distribution existed locally and worldwide. Conclusion: Factors including selection criteria; biopsy rate and indications; local facilities; demographic distribution; racial, ethnic and genetic differences; and prevalence of etiological factors contribute to the variations of GNs distribution. National renal biopsy registry is recommended for obtaining correct distribution of GNs leading to proper prevention and treatment. Keywords: Distribution, Glomerulonephropathy, Renal biopsy, FSGS, Lupus nephritis.

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Abstract

Introduction: Mucin deregulation occurs in gastrointestinal lesions progressing to cancer. Evidences advocate utility of mucin profile to predict malignant transformation in preneoplastic colonic lesions, however data are controversial. Objectives: This clinicopathological descriptive study identifies the histochemical profiles of acidic and neutral mucins in human colonic tissues including inflammatory, non-neoplastic and neoplastic lesions. Mucin alteration in different histological grades of adenocarcinoma is also evaluated. Materials and Methods: After collection of relevant data, tissue samples from a cohort of 88 patients recruited from King Abdul Aziz Specialized Hospital, Taif, Saudi Arabia were examined. Dual Alcian Blue (AB; pH 2.5)/ Diastase (D) Periodic Acid Schiff (PAS) technique was used to differentiate acidic and neutral mucins respectively. Statistical analysis including descriptive statistics, Pearson’s chi-square test and linear regression was performed using SPSS. Results: Acidic and neutral mucins were positive in 67.1 and 46.6% of lesions, respectively. All ulcerative colitis tissues were positive for acidic mucin and 75% for neutral mucin. All non-neoplastic polyps were positive for both mucins. Adenomatous polyps demonstrated reduced mucin but more neutral (59.3%) than acidic one (44.4%). About 86% of adenocarcinomas revealed acidic mucin and 22.2% showed neutral mucin with trends for acidic mucin to decrease with grade and for neutral mucin to increase with grade. Conclusion: Altered both acidic and neutral mucin profiles occur in colonic lesions of different pathologies. As colonic adenocarcinoma progresses from grade 1 to grade 3, acid mucin declines with a corresponding increase in neutral mucin. Mucin profile may be of value in evaluating the preneoplastic colorectal lesions. Keywords: Adenocarcinoma, Acidic mucin, Colon, Histochemistry, Neutral mucin.

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