Value of Electron Microscopy in the Diagnosis of Glomerular Diseases

Abstract

To evaluate the contribution of electron microscopy to the final diagnosis of glomerulopathies, the authors established a prospective study during the first semester of 2006. A total of 52 kidney biopsies were performed with 3 samples for light microscopy, immunofluorescence, and electron microscopy. Among these renal biopsies, only 20 were examined with electron microscopy because the diagnosis made on the basis of conventional methods had remained unclear or doubtful. In 18 cases, electron microscopy was undertaken for the investigation of primary kidney disease. The 2 remaining cases were transplant biopsies. In this series of 20 patients, there were 3 children with an average age of 9 years and 17 adults with an average age of 35.5 years. Fifteen patients (75%) were nephrotic. The study revealed that electron microscopy was essential for diagnosis in 8 cases (40%) and was helpful in 12 cases (60%). In conclusion, the results showed that the ultrastructural study provides essential or helpful information in many cases of glomerular diseases, and therefore electron microscopy should be considered an important tool of diagnostic renal pathology. As was recommended, it is important to reserve renal tissue for ultrastructural study unless electron microscopy can be routinely used in all biopsies. Thus, this technique could be performed wherever a renal biopsy has to be ultrastructurally evaluated.

Keywords:

• diagnosis
• electron microscopy
• glomerulonephritis
• immunofluorescence microscopy
• light microscopy
• renal biopsy
• renal transplant

ACKNOWLEDGMENTS

The authors would like to thank Aouatef Ben Ammar and Ismahène Aouadi, both members of the Electron Microscopy Laboratory, for their excellent technical assistance. The authors are also grateful for the technical collaboration from all members of the Laboratory of kidney Pathology 02 of the department of Nephrology and Internal Medicine (M8).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.