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Anatomopathological Profile of Primary Focal and Segmental Glomerulosclerosis in Children in Dakar: A Case Report of 61 Cases

Introduction: Focal and Segmental Glomerulosclerosis (FSGS) associates three types of glomerular lesions: Cellular alterations which are initially on podocytes; hyaline deposits and sclerosis. Our objective was to classify focal and segmental glomerulosclerosis (FSGS) lesions found in children in Dakar.

Patients and methods: This was a retrospective and descriptive study during the period starting from the 1st of January 1994 to 31st December 2014. Were included in the study patients aged 0 to 15 years and presenting at least one FSGS typical glomerular lesion according to the Columbia 2004 classification.

Results: Of the 150 renal biopsies performed on the children, 40.7% (n=61) presented typical FSGS lesions. The average age of children was 11.07 ± 3.81 years. The sexratio was 1.34. Nephrotic syndrome was found in 93.4% (n=57) of the children, and renal biopsy was performed for steroid resistance in 54.4% (n=31) of them. Optical microscopy (OM) was used in 100% of the cases and immunofluorescence (IF) performed in 52.5% (n=32) of them. IF was positive in 56.30% (n=18). FSGS classic form of represented 67.2% (n=41) of the cases, cellular FSGS 14.7% and collapsing FSGS 10% of them. Etiological research was negative in all of our patients. The Progression was précised in only 26.22% (n=16) of cases with half of them 50% (n=8) already on end stage renal disease.

Conclusion: FSGS revealed itself through steroid resistance in 54.4% in our series. Renal biopsy showed a higher occurrence of the classic form.

Author(s): Kéita Y, Dial CM, Sylla A, Sow A*, Ly F, Faye M, Nzambaza JD, Ndongo AA, Ka El HF, Diouf B and Sall MG

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