Hamid Nasri
1*, Mojgan Mortazavi
2, Ali Ghorbani
3, Heshmatollah Shahbazian
3, Soleiman Kheiri
4, Azar Baradaran
5, Afsoon Emami-Naieni
2, Maryam Saffari
1, Saeed Mardani
6, Ali Momeni
6, Yahya Madihi
2, Milad Baradaran-Ghahfarokhi
7, Mahmoud Rafieian-Kopaie
8, Parin Hedayati
2, Shahzad Baradaran
9, Mohammadreza Ardalan
10, Shahram Sajjadieh
2, Naziheh Assarzadegan
11, Seyed Mohammad Ahmadi Soleimani
12, Mohamad Reza Tamadon
131 Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan,Iran.
2 Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan , Iran.
3 Department of Nephrology, Ahvaz Jundishpur University of Medical Sciences, Ahvaz, Iran.
4 Department of Biostatistics and Epidemiology, Faculty of Health,Shahrekord University of Medical Sciences, Shahrekord, Iran.
5 Department of Pathology, Isfahan University of Medical Sciences, Isfahan , Iran.
6 Department of Nephrology, Shahrekord University of Medical Sciences, Shahrekord, Iran.
7 Medical Physics and Medical Engineering Department,Isfahan University of Medical Sciences ,Isfahan, Iran.
8 Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
9 Division of Renal Immunopathology, Dr. Baradaran Laboratory, Isfahan, Iran.
10 Department of Nephrology, Tabriz University of Medical Sciences, Tabriz , Iran.????
Abstract
Background: There is a limited knowledge about the morphological features of IgA
nephropathy (IgAN)in the middle east region.
Objectives: The objective of this study was to evaluate the spectrum of histopathological
findings in IgAN patients at our laboratory.
Patients and Methods: At this work, an observational study reported which was conducted
on IgAN patients using the Oxford-MEST classification system.
Results: In this survey, of 102 patients 71.6 % were male. The mean age of the
patients was 37.7 ± 13.6 years. Morphologic variables of MEST classification was
as follows; M1: 90.2 %, E: 32 %, S: 67 % also,T in grads I and II were in 30% and
19% respectively, while 51% were in grade zero. A significant difference was observed
in segmental glomerulosclerosis (P=0.003) and interstitial fibrosis/tubular
atrophy frequency distribution (P= 0.045), between males and females . Furthermore,
it was found that mesangial hypercellularity was more prevalent in yonger
patients. Moreover, there was a significant correlation between serum creatinine
and crescents (P<0.001). There was also significant correlation of serum creatinine
with segmental glomerulosclerosis (P<0.001).
Conclusions: Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/
tubular atrophy, as the two of, four variables of Oxford-MEST classification of
IgAN in male patients further attests that male gender is a risk factor in this disease.
In this study the significant correlation between serum creatinine and crescent was
in an agreement with previous studies and suggests for the probable accomodation
of extracapillary proliferation as a new variable in MEST system.
Implication for health policy/practice/research/medical education:
The prevalence and clinical picture of IgA nephropathy (IgAN) varies from region to region. There is a limited knowledge
about the morphological features of this disease according to recent Oxford-MEST classification in Iran and Middle East.
In this study higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/tubular atrophy as the two of four
variables of this classification in male patients further attests that male gender is a risk factor in this kind of disease. Significant
correlation between serum creatinine and extracapillary proliferation was in an agreement with previous studies and was suggested
for the probable accommodation of crescent as a new variable in the MEST system.
Please cite this paper as: Nasri H, Mortazavi M, Ghorbani A, Shahbazian H, Kheiri S, Baradaran A, Emami-Naieni A, Saffari M,
Mardani S, Momeni A, Madihi Y, Baradaran-Ghahfarokhi M, Rafien-Kopaie M, Hedayati P, Baradaran S, Ardalan MR , Sajjadieh
S, Assarzadegan N, Ahmadi Soleimani SM, Tamadon MR. Oxford-MEST classification in IgA nephropathy patients:
A report from Iran. J Nephropathology. 2012; 1(1): 31-42. DOI: 10.5812/jnp.7