ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
The Analysis Of 35 Cases Who Underwent Renal Biopsy With The Probable Diagnosis Of Rapidly Progressive Glomerulonephritis
Mustafa Güllülü*, Alpaslan Ersoy**, İsmail Aslanhan***, Şafak Güçer****,
Mahmut Yavuz*, Kamil Dİlek*****, Gülaydan Fİlİz******,
Keriman TInaztepe*******, Mustafa Yurtkuran*****
* Doç.Dr., Uludağ Üniversitesi Nefroloji BD,
** Uz.Dr., Uludağ Üniversitesi Nefroloji BD,
*** Araş.Gör.Dr., Uludağ Üniversitesi İç Hastalıkları AD,
**** Doç.Dr., Hacettepe Üniversitesi Pediatrik Nefropatoloji BD,
***** Prof.Dr., Uludağ Üniversitesi Nefroloji BD, BURSA
****** Uz.Dr. Uludağ Üniversitesi Patoloji AD,
******* Prof.Dr., Hacettepe Üniversitesi Pediatrik Nefropatoloji BD, ANKARA
Purpose: It's very necessary to diagnose a rapidly progressive glomerulonephritis (RPGN) case as soon as possible. In this study, we evaluated retrospectively 35 patients who were referred to our center due to the progressive loss in renal functions and put forward the diagnosis with biopsy in whom indicated.
Materials and Methods: 35 patients who were hospitalized in Uludağ University Medical Faculty Nephrology Clinic due to rapid renal function loss between 1986 to 2000 years were included into the study. All cases underwent renal biopsy because of the rapid progression.
Result: In the evaluation of the biopsy specimens crescentic glomerulonephritis was detected in 25 cases, and acute exacerbations of chronic glomerulopathy in 10. Seven of 10 cases with chronic glomerulopathy had proliferative type of diffuse glomerulosclerosis. In all cases with cresentic glomerulonephritis, at least 50 percent of the glomeruli contained crescents. They were diveded into three groups according to immunofluorescence staining: group I with linear deposition for IgG with or without C3, group II with granular depositions for immunglobulins and complements, and group III with negative or only localized positive fluorescence for immunglobulins and complements. 3 cases in group II had the features of immune complex disease. But the light microscopic and immunofluorescence findings and clinical-laboratory datas of these 3 cases were not sufficient to provide their diagnosis. Among 7 cases in group III, 3 had p-ANCA positivity and 3 had c-ANCA positivity.
Conclusion: In this retrospective analysis, we detected that 28.6% of the patients who were assumed to have RPGN had acute attack of chronic glomerulopathies, 71.4% had crescentic glomerulonephritis. As a result, biopsy is indicated in the early period of the disease in order to verify the diagnosis, prevent acute egsazerbations and unnecessary intensive immunosupressive treatment and treat the patients before the irreversible period is reached.Keywords: Crescentic glomerulonephritis,Turkiye Klinikleri J Med Sci 2001, 21:245-248
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