Abstract: FR-PO728
Dense Deposit Disease: Is There a Racial Difference in the Prevalence?
Session Information
- Clinical/Diagnostic Renal Pathology and Lab Medicine - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Glomerular
- 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine
Authors
- Abraham, Anila, Renopath, Center for Renal and Urological Pathology, Chennai, India
- Walker, Patrick D., Arkana Laboratories, Little Rock, Arkansas, United States
Background
Dense deposit disease(DDD) is a rare glomerulonephritis that commonly affects children. It is defined at the ultrastructural level by the presence of extremely electron dense material in the lamina densa of the glomerular basement membrane.This results in various patterns of glomerular injury with mesangioproliferative and membranoproliferative patterns being the most common
Methods
Native kidney biopsies reported from August 2013 to November 2016 at Renopath, Chennai, Tamil Nadu, India were reviewed. Cases of DDD were identified and clinicopathologic features compared. We then compared our findings with data published in literature.The databases at Renopath and Arkana Laboratories were utilized to compare the rates of DDD diagnosis
Results
During the study period, there were 25 patients with DDD among the 7335 native kidney biopsies (0.34%) at Renopath. Arkana Laboratories in Little Rock, AR, USA, had 21 cases of DDD among their 26,319 native kidney biopsies (0.08%) during the same time period. The mean age of patients was 20.7 years, with only 9 (36%) patients < 16 years of age. Male to female ratio was 1.3:1. Serum C3 was decreased in all patients. At the time of biopsy, proteinuria was present in all patients, five were hypertensive, 2 had partial lipodystrophy and one had drusen. Membranoproliferative, mesangioproliferative, exudative and crescentic patterns were observed. Only 52% of the biopsies showed membranoproliferative pattern. Interstitial inflammation was significantly higher in the biopsies with this pattern. All the patients with crescentic pattern (16%) were below 16 years of age. Mesangioproliferative pattern was seen only in adults. Arteriosclerosis, interstitial fibrosis and tubular atrophy were significantly more frequent in adults
Conclusion
The mean age of patients in our study was 20.7 years, unlike many studies which considered DDD as a childhood disease. Only half of our patients had the membranoproliferative pattern of glomerular injury. Crescentic pattern was seen exclusively in children and mesangioproliferative pattern was seen only in adults. Although DDD is rare, it is much more common (>400%) in this Indian population when compared with the American population. In addition to genetic differences, environmental factors and chronic infections may possibly contribute to the high incidence in this South Indian population