Prognostic Value and Histologic Correlation of Sonography in Childhood Nephrotic Syndrome

Cheon, Hae-Won; Yoo, Kee-Hwan; Hong, Young-Sook

J Korean Soc Pediatr Nephrol > Volume 2(1); 1998 > Article

J Korean Soc Pediatr Nephrol 1998;2(1): 26-33.

신증후군 환아에서 신장초음파의 예후적 가치 및 조직검사와의 상관관계에 대한 연구

전혜원, 유기환, 홍영숙

¹고려대학교 의과대학 소아과학교실
²고려대학교 의과대학 소아과학교실
³고려대학교 의과대학 소아과학교실

Prognostic Value and Histologic Correlation of Sonography in Childhood Nephrotic Syndrome

Hae-Won Cheon, Kee-Hwan Yoo, Young-Sook Hong

¹Department of Pediatrics, Korea University, College of Medicine
²Department of Pediatrics, Korea University, College of Medicine
³Department of Pediatrics, Korea University, College of Medicine

ABSTRACT

This retrospective study was designed to evaluate the prognostic value and histologic correlation of sonography in childhood nephrotic syndrome. Sixty-nine patients with proteinuria over 2g per day at the time of presentation who were treated at the Korea University Hospital were included in this review. They were 1 to 15 years old(mean age, 7.8 years) with 49 males and 20 females. In each patient an ultrasound examination was done using SPA 1000(Diasonics, C.A., U.S.A.) on admission. Tissue specimens were obtained from 46 patients. The paraffin-embedded specimens were reviewed with special reference to interstitial edema, interstitial fibrosis, tubular atrophy, global sclerosis or inflammatory cell infiltrates. Biopsy proven renal disease were minimal change disease(n=20), focal segmental glomerulosclerosis(n=7), membranous glomerulonephritis(n=2), membranoproliferative glomerulonephritis(n=1), $Henoch-Sch""{o}nlein$ purpura nephritis(n=6), IgA nephropathy(n=5), poststreptococcal glomerulonephritis(n=2), systemic lupus erythematosus(n=1) and Alport syndrome(n=2). There was a significant relationship between increased cortical echogenicity and global sclerosis or tubular atrophy(P<0.05). But no significant relationship was found between increased cortical echogenicity and interstitial fibrosis, interstitial edema, or inflammatory cell infiltration. In biopsy-proven primary nephrotic syndrome(n=30), no significant relationship was found between the increased conical echogenicity and the interstitial edema, interstitial fibrosis, global sclerosis, tubular atrophy or inflammatory cell infiltration. But there was a significant relationship between increased cortical echogenicity and resistance to corticosteroid (P<0.05). These results suggest that increased cortical echogenicity may be due to tubular atrophy or global sclerosis in patients with proteinuria and may be an effective indicator of resistance to corticosteroid in primary nephrotic syndrome.>

Key words: Childhood nephrotic syndrome | Renal cortical echogenicity | Resistance to corticosteroid