Introduction:
Renal biopsies are essential for diagnosing kidney diseases, particularly for evaluating immunoglobulin and complement deposits. Immunofluorescence (IF) is the preferred method for this evaluation; however, its unavailability in Senegal has led to the adoption of immunohistochemistry (IHC) at the Pathology and Cytology Laboratory of Cheikh Anta Diop University in Dakar. This study describes the epidemiological profile, morphological characteristics, and the contribution of IHC to the diagnosis of renal biopsies.
Methods:
This prospective study was conducted from September 1, 2023, to August 31, 2024. Renal biopsies requiring immunohistochemical complementation for an accurate diagnosis were included, compensating for the absence of immunofluorescence.
Results:
The study involved 117 cases. In 53% of the cases, IHC results were consistent with the initial histology, confirming the diagnosis. However, in 43% of the cases, IHC allowed for a more precise diagnosis, highlighting its importance in the absence of IF. A depleted sample was noted in 4% of the cases. The average age of the patients was 33 years, with a sex ratio of 0.95 (49% male and 51% female). The main pathologies observed were lupus nephritis (32%), lipoid nephrosis (24%), membranous glomerulonephritis (21%), and amyloidosis (6%). In 5% of the cases, IHC did not clarify the diagnosis, leading to non-specific pathologies such as thrombotic microangiopathy, chronic tubulointerstitial nephropathy, and immune-allergic nephritis.
The study involved 117 cases. In 53% of the cases, IHC results were consistent with the initial histology, confirming the diagnosis. However, in 43% of the cases, IHC allowed for a more precise diagnosis, highlighting its importance in the absence of IF. A depleted sample was noted in 4% of the cases. The average age of the patients was 33 years, with a sex ratio of 0.95 (49% male and 51% female). The main pathologies observed were lupus nephritis (32%), lipoid nephrosis (24%), membranous glomerulonephritis (21%), and amyloidosis (6%). In 5% of the cases, IHC did not clarify the diagnosis, leading to non-specific pathologies such as thrombotic microangiopathy, chronic tubulointerstitial nephropathy, and immune-allergic nephritis. In 4% of cases, the diagnosis of IgA nephropathy was established. Mixed cryoglobulinemia and COVID-related nephropathy were found in 2% of cases each.
Conclusions:
The absence of immunofluorescence prompted the adoption of IHC, which has proven to be a valuable alternative, providing improved diagnostic accuracy in many cases. These results underscore the importance of IHC in resource-limited settings while highlighting the need to improve access to IF for optimal diagnosis.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.