Background

IgA nephropathy and MPGN are common glomerulonephritis in the world that progresses slowly and renal function can even remain unchanged for decades. Clinically, it presents by isolated hematuria, proteinuria. Histologically, IgA nephropathy presents with acute glomerular damage, mesangial cell proliferation, endocapillary leucocyte infiltration, and crescent formations, these lesions can undergo resolution with sclerotic healing. Since 2013, renal biopsy has been done at the First Central Hospital of Mongolia a few times. However, the confirmative diagnosis of IgA nephropathy and MPGN remain unknown in Mongolia by renal biopsy. Therefore, we intended to test renal biopsy techniques and confirm its diagnosis by renal biopsy at the Second Central Hospital of Mongolia.

Methods

Ultrasound guided renal biopsy had been done for four patients by nephrologist at the Department of Nephrology of the Second Central Hospital of Mongolia. All four specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgG, IgM, IgA and complement component 3 (C3). Each case was screened by three pathologists.

Results:

The case which shows mesengial widening, mesengial hypercellularity under the light microscopy or mesangial granular deposition of IgA and C3 by immunofluorescence was diagnosed as IgA nephropathy. We obtained crescent formation with glomerular adhesion in most cases. In addition, we observed secondary MPGN in one case, which is caused by hepatitis C virus infection. 

Conclusion: Probably, it is a new step for developing pathologic diagnosis for nephrology in Mongolia. We needs further study for improving renal biopsy technique and confirming the diagnosis of IgA nephropathy and MPGN using electron microscopy and pathological report by oxford classification for IgA nephropathy.

Key words: glomerulonephritis, IgA, MPGN

Pp. 35-41, Table 1, Figures 5, References 24

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