Nadia G. El-Hefnawy

Contribution of Electron Microscopy to the Final Diagnosis of Renal Biopsies in Egyptian Patients

There are few publications studying the impact and cost benefit relationship of electron microscopy in the diagnosis of glomerulopathies in routine service. The aim of this study is to assess the contribution of EM to the final diagnosis of renal glomerular diseases in Egyptian patients. Retrospective evaluation of 120 renal biopsy specimens received for primary diagnosis at EM center of Ain Shams university Specialized hospital, Cairo Egypt during 2007in the knowledge of light microscopic, immunofluorescence and electron microscopic findings. It was found that EM was essential for diagnosis in 25% of renal biopsies, corresponding to 100% of hereditary glomerulopathies and 23.5% of other glomerulopathies, It was useful to the dignosis in 41.67% of the cases, confirming the preliminary diagnosis. In 33.33% of cases EM was considered unhelpful in diagnosis. It’s concluded that the importance of EM has not decreased during the last years. New glomerular diseases and variants can be diagnosed only by EM as fibrillary glomerulonephritis and immunotactoid glomerulopathy. Routine evaluation of allograft biopsies should include EM to achieve better recognition of capillary lesions of chronic rejection. EM provides useful diagnostic information in about 66% of native renal biopsies. Kidney biopsy protocols should include EM in all biopsy cases. If electron microscopy cannot be performed routinely on all such biopsies, tissue should be reserved for EM studies.

Aggressive low grade middle ear adenocarcinoma with multiple recurrences: a case report.

BackgroundPrimary tumours of the middle ear are much less commonly encountered in clinical practice than non neoplastic lesions. Middle ear adenocarcinoma is a very rare, locally invasive neoplasm assumed to arise from the middle ear mucosa. Because the natural course and clinical behavior of this neoplasm are far from established, the sporadic reports of such cases continue to provide basis for better understanding.Case descriptionA case of low grade adenocarcinoma of the middle ear is described in details with regard to its clinical presentation, radiological findings, histopathological, immunohistochemical and ultrastructural findings. The tumour recurred four times.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1687201235406811.

Evaluation of endothelial protein C receptor in patients with systemic lupus erythematosus: correlation with disease activity and lupus nephritis

Introduction Systemic lupus erythematous (SLE) is a systemic, multifaceted inflammatory disease with clinical manifestations is protean and follows a relapsing and remitting course. Lupus Nephritis (LN) is one of the most frequent and serious manifestation. Endothelial protein C receptor (EPCR) is a transmembrane receptor that is shed into soluble form (sEPCR) in inflammatory status. It is demonstrated as a part of the pathobiology of the SLE disease. Aim of the work To assess correlation of sEPCR level in SLE patients to the disease activity in these patients and to relate sEPCR to LN. Patients and methods Serum level of sEPCR using enzyme-linked immunosorbent assay (ELISA), chemical and immunological markers of SLE were measured in 30 SLE patients and 30 age and sex matched apparently healthy controls. SLE patients were subgrouped into 20 patients without LN and 10 with LN. Disease activity was assessed using SLE Disease Activity Index (SLEDAI). Results A significantly higher sEPCR level was found on comparing SLE patients to controls with statistically highly significant difference (z = 4.8, P < 0.001). Moreover, there was a significantly higher sEPCR level on comparing SLE patients with LN to those without LN with statistically highly significant difference (z = 3.9, P < 0.001). Serum sEPCR had a highly significant positive correlation with SLEDAI in SLE patients (r = 0.66, P < 0.01). Conclusion sEPCR has a possible role in the pathogenesis of SLE and particularly LN diseases, reflecting disease activity in SLE patients.