مقالههای Ejaz Ahmed
توجه: محتویات این صفحه به صورت خودکار پردازش شده و مقالههای نویسندگانی با تشابه اسمی، همگی در بخش یکسان نمایش داده میشوند.
۱Frequency and clinicopathological characteristics of variants of primary focal segmental glomerulosclerosis in adults presenting with nephrotic syndrome
اطلاعات انتشار: Journal of nephropathology، دوم،شماره۱، Jan ۲۰۱۳، سال ۰
تعداد صفحات: ۸
Background: There is no information on the frequency and clinicopathological presentation of the variants of primary focal segmental glomerulosclerosis (FSGS) in adults presenting with idiopathic nephrotic syndrome (INS) in Pakistan..Objectives: The aim of this study was to determine the frequencies of different histologic variants of primary FSGS with INS at our center and to compare our findings with those published in literature..Patients and Methods: All consecutive adults (≥18 years) with INS, and diagnosis of FSGS on renal biopsies, were included. Their clinicopathological features at the time of presentation were retrieved and compared among the variants..Results: There were 120 (65.2%) males and 64 (34.8%) females. The mean age was 30.62±12.02 years. The mean 24–hr urinary protein excretion was 4.69±2.36 grams. Microscopic hematuria was found in 30 (16.3%) patients. The mean serum creatinine was 1.58±0.87 mg\dL. At presentation, 128 (69.6%) patients were normotensive, while 56 (30.4%) exhibited hypertension. FSGS, not otherwise specified (NOS) was the predominant variant, comprising 76.6% of all; collapsing variant comprised 12%, tip variant, 9.8%, perihilar, 1.1%, and cellular, 0.5%. The mean number of glomeruli involved by segmental scarring was 3.41±2.87 and there was significant difference among the variants (p= 0.001). Arteriolopathy was found in 23.4 % cases and fibrointimal thickening of arteries in 18.5%. Tubular atrophy and interstitial fibrosis (IF\TA) was noted in 93% of cases. There was no significant difference in vasculopathy and IF\TA among the variants..Conclusions: Collapsing variant was the second most common variant following NOS and these findings are different from other regional studies..
۲Prevalence of anti– beta2GPI antibodies and their isotypes in patients with renal diseases and clinical suspicion of antiphospholipid syndrome
اطلاعات انتشار: Journal of nephropathology، دوم،شماره۳، Jul ۲۰۱۳، سال ۰
تعداد صفحات: ۹
Background: Antiphospholipid antibodies (aPL) are autoantibodies that are associated with a clinical state of hypercoagulability and diverse clinical manifestations collectively known as antiphospholipid syndrome (APS).Objectives: To investigate the prevalence of anti–beta2glycoproteinI–antibodies (anti–β2GPI) and their isotypes in patients with renal diseases and clinical suspicion of antiphospholipid syndrome (APS).Patients and Methods: This is a retrospective study in which we have analyzed the prevalence of anti–β2GPI and its isotypes in 170 patients on initial testing and in 29 patients repeated after 12 weeks for confirmation of APS. The clinical information was provided by the treating physicians or retrieved from the clinical records. The tests for anti–β2GPI screening and its isotypes (IgG, IgM and IgA) detection were assessed.Results: On initial samples, anti–β2GPI was positive in 118patients. IgA–β2GPI positivity (93; 79%) was significantly higher than IgM and IgG isotypes. Out of anti–β2GPI positive patients, clinical features in 95 patients were suggestive of APS or had SLE. Of these, IgA isotypes was found in 66% (P = 0.010), IgM in 31% (P = 0.033), and IgG in 11% (P = 0.033). On repeat testing, anti–β2GPI was persistently found In 22 patients with a continual predominance of IgA–anti– β2GPI over IgM and IgG isotypes (91% vs. 45.5% and 18% respectively).Conclusions: Our results show that IgA–anti–β2GPI antibodies are the most prevalent isotypes in patients with renal disease or on renal replacement therapy in our population. Thus inclusion of IgA–anti–β2GPI in the testing repertoire may increase the diagnostic sensitivity for APS in patients with renal diseases.
۳Prevalence and risk factors for early chronic allograft nephropathy in a live related renal transplant program
نویسنده(ها): Hamid Khan، Muhammed Mubarak *، Tahir Aziz، Ejaz Ahmed، Syed Fazal Akhter، Javed Kazi، Syed AA Naqvi، Syed AH Rizvi
اطلاعات انتشار: Journal of nephropathology، سوم،شماره۲، Apr ۲۰۱۴، سال ۰
تعداد صفحات: ۱۱
Background: Chronic allograft nephropathy (CAN) is a common cause of delayed allograftfailure throughout the world. Its prevalence and risk factors vary depending on a number offactors. There is little information on the prevalence and risk factors for early CAN in liverelated renal transplant patients.Objectives: We aimed to determine the prevalence and the risk factors of early CAN in our setup.Patients and Methods: The study was conducted at Sindh Institute of Urology & Transplantation(SIUT), Karachi, from 2002 to 2005 on patients who had live related kidney transplantationand underwent at least one allograft biopsy within 18 months of transplantation. Thebiopsies were performed and prepared in accordance with established indications andguidelines. The Banff 97 classification and its updates were used to diagnose and categorizethe biopsy pathology. Patients were divided into two groups depending on the presence orabsence of CAN on biopsies. Following parameters were compared among the groups: age,sex, human leukocyte antigen (HLA) match, immunosuppression used, acute rejection (AR)episodes, urinary tract infections (UTIs), viral infections, cyclosporine levels, early and lategraft function monitored by serum creatinine.Results: A total of 164 patients fulfilled the study inclusion criteria. The mean age of recipientsand donors was relatively young. The majority of the donors were siblings. The overallprevalence of CAN was 25.6% (42\164), between 3 and 18 months post transplantation.The median time to the appearance of CAN was 9 months post–transplant. The prevalenceof CAN increased as post–transplant duration increased. In 39 (92.8%) subjects, CAN wasdetected on the second or subsequent graft biopsy. Only 3 (7.2%) patients showed CAN onthe first graft biopsy. The majority of cases belonged to moderate degree or grade II CAN.The mean serum creatinine values were higher in the CAN group at the time of dischargeand all times post–transplantation.Conclusions: In conclusion, the results show that serum creatinine at the time of discharge isa useful predictor of later development of chronic changes in the allograft. Further studiesare needed to identify the risk factors for the early development of chronic changes in livingrelated renal transplant program.
۴Gitelman’s syndrome complicated by mild renal insufficiency and high anion gap acidosis; a rare presentation in a young female
اطلاعات انتشار: Journal of nephropathology، چهارم،شماره۲، Apr ۲۰۱۵، سال ۰
تعداد صفحات: ۵
Background: Gitelman’s syndrome (GS) is a rare autosomal recessive renal tubular disorder that is characterized by episodic clinical manifestations and persistent biochemical abnormalities. The disorder manifests in adolescent or adult age and is characterized by transient episodes of muscle weakness and tetany. Its diagnosis requires a high index of suspicion and skillful interpretation of laboratory investigations. Case Presentation: We herein present a case of a 20–year–old female patient who presented with generalized muscle weakness and mild renal insufficiency. Laboratory investigations revealed mild azotemia, high anion gap acidosis, hypokalemia, hypomagnesemia, and hypocalciuria. She recovered her renal functions and muscle power with appropriate management and is doing well seven months after her first presentation to our hospital. Conclusions: This case highlights the need to create high index of suspicion among the general practitioners about this syndrome and an early referral of such patients to nephrologists for an accurate diagnosis and appropriate management.
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