Immune deposits in glomerular diseases and their clinical, histopathological and immunopathological correlation

Abstract

Glomerulonephritis (GN) is a common renal disease attributing to chronic renal failure (CRF). Early diagnosis and treatment of GN depends on urine and blood examination followed by light and immunofluorescent microscopic study of renal biopsy. Aim of this study was to demonstrate the frequency, pattern and site of deposition of immunoglobulin IgG, IgA, IgM and C3 by direct immunofluorescence (DIF) microscopic technique in different types of GN and to correlate their association with clinical and histopathological findings. In this study, majority of the cases were in the 21-30 years age group (27.27%). Most frequent clinical presentation of glomerulonephritis was nephrotic syndrome (61.22%; n=98) and commonest type of glomerulonephritis was mesangioproliferative GN (40.81%). Among 98 cases studied, 49 cases (50%) were DIF positive. The most frequent type of depositions were C3 in various combinations (98%) followed by IgG (67.35%) and IgA (40%). Most common site of immune deposit was mesangium followed by glomerular basement membrane. Granular deposition was the most frequent pattern of immune deposition. Immune-depositions were present in all cases of IgA nephropathy, membranous, diffuse proliferative and membranoproliferative GN. It can be concluded that glomerular immune deposit is present in about half of the glomerulonephritis and the frequency and type of deposition vary with the type of GN.