Clinical, morphological, immunological correlation of kidney biopsies and prognostication

Twenty seven ANA and dsDNA positive cases were selected from surgical files from years 1986 to 1997. Clinical, biochemical, morphological and immunofluorescence findings were correlated. Routine Haematoxylin and Eosin, Per iodic-Acid-Schiff and Methaneamine-Silver stains were used for all cases. Direct immunofluorescence was done whenever possible. Morphologically cases were grouped as per WHO criteria. Morphologically cases were quantified into Austin's chronicity and activity indices. Twenty one to thirty years was common age group. M:F:: 1:4.4. Anemia, skin rash and arthralgia were common extra-renal manifestations. There were 1,5,7,10 and three cases as per WHO class I to V respectively. All cases of class IV had active urine sediments and proteinuria. Four cases had high BUN and Serum creatinine levels. All (12) cases of immunofluorescence revealed group specific patterns. Five cases died. Infection was common cause of death. Twenty to thirty years, males, High BUN and Creatinine levels and high activity and chronicity indices were associated with poor prognosis.