فهرست نشریات علمی دسترسی آزاد ایران

The kidney biopsy specimen is used for initial diagnosis of patients with SLEwho at the time of biopsy lack either diagnostic clinical manifestation and or serologicalmarkers. Another role is evaluation of renal dysfunction in transplanted patients when lupushas occurred in renal allograft. The aim of this study is correlating the findings of light,immunofluorescent and electron microscopy in thirty patients with lupus nephritis.Methods: The kidney biopsies of thirty patients with SLE were studied for purpose of correlatingthe findings of light, immunofluorescent and electron microscopy. We studied 30parameters in light microscopy sections, 5 parameters in semi -thin and EM sections , andIgG, IgM, IgA, C3, C4 and fibrinogen in different structures of specimens by immunofluroscentmicroscopy. The P value and measurement of agreement of kappa was calculated.Results: In 25 cases LM and EM correlated completely including lupus nephritis class, activityand chronicity indices and presence or absence of immune complex deposition. In 5cases discrepancy between Light Microscopy and Electron Microscopy diagnosis was found.Three cases were classified as class III according to LM and class II by EM. LM reevaluationof all three cases showed focal and segmental endocapillary cell proliferation with neutrophilicinfiltration. We found that LM study is cornerstone in the focal lesions because of thelimited inclusion of glomeruli in EM. One case of class IV by LM, in EM shows massive(grade III) sub-epithelial depositions and grade I sub endothelial deposition and was classifiedit as Class V + VI. In LM, findings cellular crescent in six glomeruli, severe endocapillarycell proliferation with activity index of (16/24) were detected. So the correct diagnosiswas Class V + VI. The last case classified as IV in LM classification and revealed moderatemesangial cell proliferation with obliteration of lumens. In EM, we had three glomeruliwhich all showed mesangial cell proliferation, grade II mesangial deposition, with one focusof small (grade I) sub endothelial deposition. According to the above-mentioned findingsthe EM class of patient was class II.Conclusion: We found that there is agreement between EM and semi-thin sections for detectionof exact site of depositions as well as their grading. Study of semi-thin sections byLM can demonstrate the deposits that are observed on EM.