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Detection of immunoglobulins and complement components in formalin fixed and paraffin embedded renal biopsy material
Muhammed Mubarak1, I Kazi Javed1, Umme Kulsoom1
1Histopathology Department, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
Insights
Direct immunofluorescence (IF) on paraffin-embedded kidney biopsies can diagnose most immune complex-mediated glomerular diseases. While less sensitive than fresh-frozen tissue (IF-F), FFPE IF offers a viable diagnostic alternative.
Area of Science:
- Nephrology
- Immunopathology
- Diagnostic Pathology
Background:
- Direct immunofluorescence (IF) is crucial for diagnosing renal glomerular diseases.
- Optimal IF results are achieved with fresh-frozen (IF-F) tissue.
- Alternative IF techniques exist for formalin-fixed, paraffin-embedded (FFPE) renal biopsy specimens with variable success.
Purpose of the Study:
- To evaluate three techniques for IF on FFPE renal biopsy specimens.
- To compare FFPE IF results with conventional IF-F from the same patients.
Main Methods:
- FFPE renal biopsy specimens underwent heat treatment (Tris and citrate buffers) or pronase treatment.
- Direct IF was performed for renal panel immunoglobulins and complement components.
- Results were compared to historical IF-F studies.
Main Results:
- Immunofluorescence staining on paraffin sections was less sensitive and intense than IF-F for immune complex-mediated renal diseases.
- Diagnostic findings were successfully detected in the majority of cases using FFPE specimens.
Conclusions:
- Diagnosis of immune complex-mediated glomerular diseases is feasible using IF on FFPE tissue.
- FFPE IF serves as a practical alternative when fresh-frozen tissue is unavailable.
Background:
The technique of direct immunoflourescence (IF) is essential in the accurate diagnosis of renal glomerular diseases. The optimal results are obtained when the procedure is done on fresh frozen tissue (IF-F). However, techniques are available for IF study on formalin fixed and paraffin embedded (FFPE) renal biopsy specimens with variable reported success rates.
Objectives:
We evaluated three such techniques on FFPE tissue and compared the results with those obtained by IF-F from the same patients.
Materials And Methods:
Heat treatment with Tris buffer and citrate buffer, and pronase treatment of the FFPE material was carried out. Direct IF was done for renal panel immunoglobulins and complement components on all biopsies and the results were compared with the historical IF-F study.
Results:
When compared to the IF-F, the immunoflourescence staining on the paraffin sections was less sensitive and less intense in all immune complex-mediated renal diseases, but the diagnostic findings were detected in majority of the cases.
Conclusions:
In conclusion, it is possible to establish the diagnosis in most cases of immune complex-mediated glomerular diseases with IF on paraffin embedded tissue specimens.
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