Renal changes in idiopathic hematuria: clinicopathologic study of forty patients

V. Pardo, D. Levi, L. Sanchez, J. Strauss

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Abstract

Kidney biopsies from 40 patients with recurrent or persistent hematuria in the absence of any other manifestations of renal disease or urinary tract abnormalities were studied by light, electron and immunofluorescence microscopy. Mean patient age at disease onset was 15 yr and mean duration was 2.5 yr. Twenty eight patients had gross hematuria. ANA, LE and Australia antigen tests were negative. Complement and ASO titers were normal in 18/18 and 22/24 patients respectively. Histologic examination and quantitative evaluation of the number and distribution of glomerular nuclei demonstrated a segmental mesangial proliferation in 22 of the patients when compared to controls. Tubular hemorrhage was present in 25 biopsies. Electron microscopy evidenced mesangial deposits in 17/40 cases. The distinctive lamina densa changes of Alport's syndrome were observed in biopsies from 2 children. Granular deposits of a variety of immunoglobulins and/or complement were present in the mesangium of 15/17 patients studied. Only 2 patients had completely negative biopsies. Immune complexes may relate directly to the pathogenesis of the glomerular bleeding; however, no correlation was found between the presence or extent of the glomerular deposits and the incidence or degree of the glomerular proliferation or any clinical parameter. Electron microscopic images suggesting passage of RBCs through the lamina densa were seen in areas otherwise exhibiting normal ultrastructure. Kidney biopsy was of significant diagnostic value in the differential diagnosis of idiopathic hematuria from other genitourinary sources of bleeding. Immunofluorescence was the most sensitive diagnostic test.

Original languageEnglish (US)
Pages (from-to)No. 106
JournalAmerican Journal of Pathology
Volume78
Issue number1
StatePublished - Jan 1 1975

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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    Pardo, V., Levi, D., Sanchez, L., & Strauss, J. (1975). Renal changes in idiopathic hematuria: clinicopathologic study of forty patients. American Journal of Pathology, 78(1), No. 106.