Clinicopathological Analysis of Glomerulonephritis with Asymptomatic Urinary Abnormalities in Children

Sung, Ick-Ho; Yoon, Hye-Kyoung; Chung, Woo-Yeong

J Korean Soc Pediatr Nephrol > Volume 1(2); 1997 > Article

J Korean Soc Pediatr Nephrol 1997;1(2): 136-143.

무증상성 요이상을 동반한 사구체신염 환아의 임상 및 병리학적 분석

성익호, 윤혜경, 정우영

¹인제대학교 부산백병원 소아과학교실
²인제대학교 부산백병원 병리학교실
³인제대학교 부산백병원 소아과학교실

Clinicopathological Analysis of Glomerulonephritis with Asymptomatic Urinary Abnormalities in Children

Ick-Ho Sung, Hye-Kyoung Yoon, Woo-Yeong Chung

¹Department of Pediatrics, Inje University, College of Medicine, Pusan Paik Hospital
²Department of Pathology, Inje University, College of Medicine, Pusan Paik Hospital
³Department of Pediatrics, Inje University, College of Medicine, Pusan Paik Hospital

ABSTRACT

Purpose : To evaluate the prevalence and clinical manifestations of various glomerulonephritis(GN) in children with asymptomatic urinary abnormalities, a clinicopathological analysis of 134 biopsied cases which were subdivided into 3 groups of proteinuria with hematuria, isolated hematuria and isolated proteinuria was done.
Methods : We conducted retrospective study with review of histopathologic findings and clinical manifestations of the 134 cases with asymptomatic urinary abnormalities diagnosed by percutaneous renal biopsy which were done between January 1986 and December 1996 at department of pediatrics, Pusan Paik hospital.
Results : 1) The proportion of children with asymptomatic urinary abnormalities was 43.2% of all biosied cases. 2) Among these, primary GN were 95 cases and secondary GN were 39 cases, it's ratio was 2.44:1. As a whole, the most common pathologic diagnosis was IgA nephropathy(IgAN, 26.9%), which was followed by $Henoch-Sch""{o}nlein$ purpura nephritis(HSPN, 17.9%), minimal change lesion(MC, 17.2%), thin GBM disease(12.7%), Hepatitis B associated glomerulonephritis(HBGN, 6.0%), poststreptococcal glomerulonephritis(PSAGN, 3.0%), mesangial proliferative glomerulonephritis(MesPGN, 2.2%), membranoproliferative glomerulonephritis (MPGN, 2.2%), Alport syndrome (1.5%) and Fibrillary nephritis(0.7%). 3) In proteinuria with hematuria, the most common pathologic diagnosis was IgAN(34.6%), which was followed by HSPN(19%), MC(17.7%), thin GBM disease(8.9%), HBGN(6.3%), PSAGN(3.6%), MesPGN(1.2%), MPGN(1.2%) and Alport syndrome(1.2%). 4) Major causes of isolated hematuria were thin GBM disease(19.6%), IgAN(17.6%), HSPN(17.6%), MC(11.8%). 5) Isolated proteinuria was due to of 3 cases of MC and 1 case of HBGN.
Conclusion : The prevalence of glomerulonephritis with asymptomatic urinary abnormalities in children were 43.2% of all biopsed cases. When these children were subdivided into 3 groups, proteinuria with hematuria was accounted 58.9%(79 cases) and then isolated hematuria was 38.1%(51 cases), isolated proteinuria was only 3%(4 cases) respectively. The most common pathologic diagnosis was IgA nephropathy in patient with proteinuria and hematuria, and thin GBM disease in patient with isolated hematuria.

Key words: Asymptomatic urinary abnormalities | Clinicopathological analysis | Glomerulonephritis | Renal biopsy | Children