Tag: Immunofluorescence

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jhc2026v10i2s2

Original
Lupus Nephritis; an Unrevealed Morbidity in Bangladeshi Population- A Clinical and Histomorphological Study
*Imrana,1 Islam SJ,2 Rahman TS,3 Azad A4

  1. *Dr Farah Imrana, Associate Professor, Department of Pathology, BIHS General Hospital, Mirpur-1, Dhaka. farahdr02@gmail.com. ORCID: https://orcid.org/0009-0005-0941-9638
  2. Brig Gen. Prof SK Jaynul Islam, Senior Consultant, Pathology, BIRDEM Hospital, Shahbag, Dhaka. ORCID: https://orcid.org/0000-0002-0388-4441
  3. Dr. Tanzila Subrina Rahman, Associate Professor, Pathology, Rajshahi Medical College. ORCID: https://orcid.org/0009-0000-2373-4996
  4. Dr. Afroza Azad, Associate Professor, Department of Clinical Biochemistry, BIHS General Hospital, Mirpur-1, Dhaka. ORCID: https://orcid.org/0009-0005-8579-6128

Abstract
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with multi-organ involvement. SLE affect on kidneys, mostly referred to as Lupus nephritis (LN) is of special interest for three reasons. First, lupus nephritis is one of the commonest types of organ involvement in this disorder, affecting as up to 45% of all patients with SLE. Second, it presents with a great variety of clinical and histopathological findings and thirdly, it greatly affects the morbidity and mortality of SLE patients. Thus, LN is one of the most serious SLE complications and the clinicopathological findings of LN are responsible for the ultimate prognosis of SLE. But these findings show geographical variation. Data on LN of Bangladeshi patients are rare in  literature and most of them describe mostly clinical features rather than the histomorphologic findings.
Objectives: To evaluate demographic, clinical, laboratory and histomorphological characteristics of LN patient and analyze correlations across different INS/RPS 2003 classes.
Method: A prospective, cross-sectional study was conducted at a tertiary diagnostic center in Dhaka from July 2024 to June 2025. Total fifty clinically diagnosed SLE cases with renal involvement were included in this study. The study group were underwent renal core biopsy. Histological evaluation and direct immunofluorescence (DIF) study were done on each specimen. Each case was classified according to the International Society for Nephrology/Renal Pathology Society (ISN/RPS) 2003 LN classification system and compared with the clinical, biochemical and immunological findings.
Results: The mean age was 28.3±12.2 years (range: 9-70), with female predominance (M:F ratio 1:4.5). Proteinuria was the leading presentation (96%), followed by hematuria (56%). ISN/RPS classification revealed Class IV as most frequent (40%), followed by Class III (26%). Class II (22%), Class V (08%) and Class I (04%). Proliferative LN (Class III/IV) exhibited crescent formation (30%), wire loop formation (34%) and necrotizing change (36%). Full house Immunofluorescence deposits were present in 85% of evaluable cases. Higher activity and chronicity indices were observed in Class IV lesions, correlating with worse renal function.
Conclusion: Class IV LN was the predominant and most severe subtype, strongly associated with adverse clinical, biochemical and histological features. Early renal biopsy and clinicopathological correlation remain indispensable for prognosis and therapeutic planning in Bangladeshi patients.
[Journal of Histopathology and Cytopathology, 2026 Jul; 10 (2):86-95]
DOI: https://www.doi.org/10.69950/jhc.2026.10.2.2
*For correspondence
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