engleski

The value of renal biopsy analysis in children with isolated microhematuria

Characteristic electron microscopic(EM)findings of Alport syndrome(AS)consist of irregular thickening and diffuse splitting of lamina densa of GBM.We report here the clinical course in 24 children with such GBM changes without other features of AS or family history of chronic renal failure and/or neurosensory deafness.21 of them presented sa microscopic hematuria(MH) and 3 as nephrotic syndrome(NS).There were 13 girls and 11 boys, aged 2-10 years.In patients with MH light microscopy(LM)showed minimal changes or mesangial proliferation, immunofluorescent(IF) findings were insignificant.In patients with NS mesangial proliferation was found by LM, and IF was insignificant too.Meran follow-up period was 5, 4 years.In all patients with MH hematuria persisted and in 5 proteinuria appeared too.All 3 patients with NS had relapses.In all children renal function remained normal during the whole follow-up period.Three children developed neurosensory deafness later.Examination of family members revealed hematuria in 12.Our observations suggest that children with GBM changes consistent with AS may develop overt syndrome ; therefore this EM finding deserves clinical attention and surveillance.The significance of GBM changes consistent with AS in patients with NS remains to be explained.

GBM changes consistent with Alports syndrome; electron microscopy; absense of clinical Alports syndrome

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