Role of immunoflourescence in the diagnosis of glomerulonephritis.

OBJECTIVE: To correlate the findings of immunoflorescence (IF) with morphology in renal biopsies of patients with glomerulonephritis (GN) of both primary and secondary nature. METHODS: The cross-sectional analytical study was conducted at the Shifa International Hospital's Department of Pathology form March 2007 to August 2008, during which a total of 207 renal biopsies were done. Of them, the study included 92 cases which were diagnosed as primary or secondary glomerulonephritis under light microscope. Those cases were selected in which both light microscopy (LM) and immunoflorescence were done. RESULTS: Of the 92 patients, 79 (85.8%) were adults (> or = 19 years) and 13 (14%) were children (< 19 years). The mean age of adults was 36.44 +/- 11.55 (range 19-69 years) and that of the children was 10.54 +/- 3.85 years (range 4-18 years). immunoflorescence changed the morphologic diagnosis in 20 (21.73%) cases. The pattern of disease was: membranous glomerulonephritis in 24%, focal segmental glomerulosclerosis (FSGS) in 18.4%, mesangiocapillary glomerulonephritis in 2%, and minimal change disease (MCD) in 16% of the cases. CONCLUSION: Light microscopy alone can misdiagnose renal disease. This is especially important in cases of early stage membranous, IgA nephropathy (IgAN), Lupus nephritis and IgM nephropathy (IgMN), as these entities can only be diagnosed by correlating the microscopic, immunoflorescence findings and clinical details.

Esophageal haemangioma: a case report and review of literature.

A 28-year-old female presented with the history of dysphagia to liquids. Initial evaluation through endoscopy was unremarkable and biopsy was reported negative for malignancy. Re-biopsy revealed a stricture like esophageal growth at 23 cm from upper incisors, causing narrowing of esophagus that raised suspicion of malignancy. Microscopic examination revealed dilated blood vessels lined by flattened endothelial cells. Diagnosis of esophageal cavernous haemangioma was made. Immunohistochemistry (CD34) confirmed the diagnosis. Endoscopic resection of tumor is being planned for the patient.

Comparison of the Appropriateness of Myocardial Perfusion Imaging in Men Versus Women.

After a decade of appropriate use criteria publication, the degree and predictors of inappropriate use in women compared with men are not known. We conducted a retrospective cohort investigation comparing appropriateness categories (appropriate, maybe appropriate, and rarely appropriate) and cardiovascular outcomes in patients undergoing nuclear myocardial perfusion imaging (MPI) between June 2011 and September 2014 in predominantly inpatient setting. Of 1,475 cases reviewed, 747 (50.6%) were women, and they were more likely to have rarely appropriate use 118 (15.8%) than men 62 (8.5%), p <0.01, but they were less likely to have an abnormal MPI 102 (13.6%) than men 183 (25.6%), p <0.01. Subsequent angiography and revascularization rates were similar in women 38 (37.2%) and 5 (4.9%) and men 52 (28.4%) and 16 (8.7%), p = 0.12, p = 0.23, respectively. After median follow-up of 6 months, myocardial infarction rates were similar in women 3 (2.9%) and men 7 (3.8%), p = 0.67. Death rates were similar in women 8 (7.8%) and men 18 (9.8%), p = 0.57. The most common clinical scenario designated as rarely appropriate was in those with low pretest probability of coronary artery disease, who have interpretable electrocardiogram and are able to exercise in women 58 (49.1%) and men 21 (33.8%). In conclusion, based on the most contemporary appropriate use criteria publication, rarely appropriate use of MPI remains higher in women than that in men. This phenomenon was mostly observed in low-risk patients who can exercise.