Abstract
Measurements of glomerular basement membrane (GBM) thickness in children with minimal change nephrotic syndrome were made on electron micrographs of 43 biopsy specimens obtained from 35 children aged 1–13 years, of whom 13 were in remission at the time of biopsy. Measurements were also made in 2 children with non-glomerular disorders. A mean of 189 measurements per biopsy were made, using prints of x6,400–12,000 magnification. Quadratic curves were fitted by regression analysis to the mean GBM thickness for each of the 35 initial nephrotic biopsies, plotted against age for the whole group and separately for sex, race and the presence or absence of proteinuria at the time of biopsy. There were no significant differences in race or proteinuria, but there was a trend towards a thicker GBM in young males which disappeared by 9 years of age. From the mean ±2 SD of GBM thickness for each of the 35 initial nephrotic biopsies the calculated thickness ranged from 100–340 nm at 1 year of age to 190–440 nm at 9 years of age and older. The growth curve for GBM thickness increases steeply initially, reaching a plateau at 9 years of age. Because there was no significant difference between proteinuric patients and those in remission, while measurements in the nephrotic syndrome and non-glomerular disorders closely agreed, we believe that our results demonstrate the normal GBM thickness and growth pattern.
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References
Spear GS, Slusser RJ (1972) Alport's syndrome: emphasising electronmicroscopic studies of the glomerulus. Am J Pathol 69: 213–224
Churg J, Sherman RL (1973) Pathologic characteristics of hereditary nephritis. Arch Pathol 95: 374–379
Yoshikawa N, Cameron AH, White RHR (1980) The glomerular basal lamina in hereditary nephritis. J Pathol 135: 199–209
Yoshikawa N, White RHR, Cameron AH (1982) Familial haematuria: clinico-pathological correlations. Clin Nephrol 17: 172–182
Bernstein J (1979) Hereditary renal disease. In: Churg J, Mostofi SK, Spargo B (eds) Kidney disease: present status; IAP Monograph no. 20. Williams and Wilkins, Baltimore, pp 295–326
Habib R, Gubler M-C, Hinglais N, Noel L-H, Droz D, Levy M, Mahieu P, Foidart J-M, Perrin D, Bois E, Grunfeld J-P (1982) Alport's syndrome: experience at Hôpital Necker. Kidney Int 21 [Suppl 11]: S20-S28
Gubler M-C, Levy M, Broyer M, Naizat C, Gonzales G, Perrin D, Habib R (1981) Alport's syndrome: a report of 58 cases and a review of the literature. Am J Med 70: 493–505
Østerby R (1971) Quantitative electron microscopy of the glomerular basement membrane. A methodologic study. Lab Invest 25: 15–24
International study of kidney disease in children (1974) Prospective, controlled trial of cyclophosphamide therapy in children with the nephrotic syndrome. Lancet II: 423–427
Churg J, Habib R, White RHR (1970) Pathology of the nephrotic syndrome in children: a report for the International Study of Kidney disease in Children. Lancet I: 1299–1302
Yoshikawa N, Cameron AH, White RHR (1981) Ultrastructure of the non-sclerotic glomeruli in childhood nephrotic syndrome. J Pathol 136: 133–147
Osawa G, Kimmelstiel P, Seiling V (1966) Thickness of glomerular basement membranes. Am J Clin Pathol 45: 7–20
Cox DR, Hinkley DV (1974) Theoretical statistics. Chapman and Hall, London
Tanner JM, Whitehouse RH, Takaishi M (1966) Standards from birth to maturity for height, weight, height velocity and weight velocity. British Children 1965. Arch Dis Child 41: 454–471
Haynes WDG (1981) The normal human renal glomerulus. Virchows Arch [Cell Pathol] 35: 133–158
Jorgensen F, Weis Bentzon M (1968) The ultrastructure of the normal human glomerulus: thickness of glomerular basement membrane. Lab Invest 18: 42–48
Steffes MW, Barbosa J, Basgen JM, Sutherland DER, Najarian JS, Mauer SM (1983) Quantitative glomerular morphology of the normal human kidney. Lab Invest 49: 82–86
Østerby R (1972) Morphometric studies of the peripheral glomerular basement membrane in early juvenile diabetes. I. Development of initial basement membrane thickening. Diabetologia 8: 84–92
Bloom PM, Hartmann JF, Vernier RL (1959) An electron microscopic evaluation of the width of normal glomerular basement membrane in man at various ages. Anat Rec 133: 251
Vernier RL (1961) Ultrastructure of the glomerulus and changes in fine structure associated with increased permeability of the glomerulus to protein. In: Wolstenholme GEW, Cameron MP (eds) Ciba Foundation Symposium on Renal Biopsy, Little Brown, Boston, pp 4–31
Kobayashi O, Wada H, Okawa K, Maeda H (1980) Renal glomerular changes of non-familial and familial benign hematuria. Int J Pediatr Nephrol 1: 88–92
Yoshikawa N, Hashimato H, Katayama Y, Yamada Y, Matsuo T, Okada S (1984) The thin glomerular basement membrane in children with haematuria J Pathol 142: 253–257
Milanesi C, Rizzoni G, Braggion F, Galdiolo D (1984) Electron microscopy for measurement of glomerular basement membrane width in children with benign familial hematuria. Appl Pathol 2: 199–204
White RHR, Jivani SKM (1974) Evaluation of a disposal needle for renal biopsy in children. Clin Nephrol 9: 229–235
Sharples PM, Poulton J, White RHR (1985) Steroid responsive nephrotic syndrome is more common in Asians. Arch Dis Child 60: 1014–1017
Hodson CJ, Drewe JA, Karn MN, King A (1962) Renal size in normal children: a radiographic study during life. Arch Dis Child 37: 616–622
Kantero R-L, Tiisala R (1971) Growth of head circumference from birth to 10 years. Acta Paediatr Scand [Suppl] 220: 27–32
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Morita, M., White, R.H.R., Raafat, F. et al. Glomerular basement membrane thickness in children. Pediatr Nephrol 2, 190–195 (1988). https://doi.org/10.1007/BF00862588
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DOI: https://doi.org/10.1007/BF00862588