Electron microscopy in the pathological diagnosis of pediatric nephro-immunological diseases
1 Department of Pediatrics, Medical College and Hospital, Kolkata, Kolkata- 700073, India.
2 Multidisciplinary Research Unit, Medical College and Hospital, Kolkata, Kolkata- 700073, India.
3 Department of Nephrology, North Bengal Medical College & Hospital, Siliguri, 734012, India.
4 Medical College and Hospital, Kolkata, Kolkata- 700073, India.
Research Article
International Journal of Science and Technology Research Archive, 2026, 11(01), 015–022.
Article DOI: 10.53771/ijstra.2026.11.1.0027
Publication history:
Received on 15 June 2026; revised on 27 July 2026; accepted on 29 July 2026
Abstract:
Background: Electron Microscopy (EM) can be essential in diagnosing and classifying immunological nephritis, which is vital for treatment and prognosis. However, Indian patients lack information on this topic. Hence, our study aimed to recognize the ultrastructural morphological changes in pediatric immune-mediated kidney disorders via EM.
Methods: In this prospective, longitudinal, observational study, 18 patients were enrolled. Patients were divided into three groups: lupus, familial Nephrotic Syndrome (NS), and non-familial Steroid-Resistant Nephrotic Syndrome (SRNS). A total of 15 patients were found to have lupus, whereas six patients had familial nephrotic syndrome, and 20 patients had non-familial SRNS. The EM findings and their contribution to the primary diagnosis were assigned into categories: 1) Essential, 2) Helpful, and 3) Auxiliary. One viable glomerulus (if available) and its accompanying tubule-interstitium were analyzed with transmission electron microscopy.
Results: The mean age of the patients was 7.65 years, with a minimum of 3 and a maximum of 13; most (75.6%) were girls. Podocyte effacement was present in 80.5% of cases, and subendothelial or subepithelial deposits in 49% of cases. EM was found to be essential for diagnosis in 34% of patients, important contributory information in 22%, and not contributory in 38% of cases.
Conclusion: EM helped in clinical diagnosis in the majority of the cases. This study thus encourages the inclusion of EM in the routine evaluation of all pediatric kidney biopsies.
Keywords:
Electron Microscopy; Lupus Nephritis; Immunological Diseases; Kidney Biopsies; Pediatric
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