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PRIMER GLOMERÜLONEFRITLI OLGULARıMıZıN ÖZELLİKLERİ

FEATURES OF OUR PATIENTS WITH PRIMARY GLOMERULONEPHRITIS

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Abstract (2. Language): 
The distribution of the types of primary glomerulonephritis (GN) varies from one center to another depending on ethnicity, geographical region and the indication for biopsy. It was observed that the most frequent diagnoses reached at 'our center in the last decade when the biopsy results of 283 patients (159 males, 124 females, mean age: 32.9±W, range: 15-70) diagnosed as primary GN were: membranoproliferative glomerulonephritis (MPGN) (26.6%), membranous glomerulonephritis (MGN) (23.4%) and diffuse proliferative glomerulonephritis (DPGN) (20.9%). Of the biopsied cases, 39.2% had pure nephrotic syndrome, 30.4% nephrotic+nephritic syndrome, and 25.1% nephritic syndrome. Also, 5.3% of the cases were biopsied because of asymptomatic urinary abnormalities. The most frequent diagnoses in nephrotic syndrome, nephritic syndrome, nephrotic+nephritic syndrome, and in patients.with asymptomatic urinary abnormalities were, respectively, MPGN (29.4%), DPGN (29.6%), MPGN (32.6%), and DPGN (33.3%). It is known that MPGN -the pathogenesis of which is associated with an immune-complex mechanism- has been declining in developed countries; and this condition can be explained with the decrease in infections. Although we excluded known secondary causes in our study, finding a high prevalence of MPGN might make us think that undefined infective agents still play important roles in the pathogenesis ofGN in our country.
Abstract (Original Language): 
Primer glomerülonefrit (GN) tiplerinin dağılımı ırk, coğrafi bölge ve biyopsi endikasyonuna göre merkezden merkeze değişmektedir. Merkezimizde son 10 yıllık dönemde primer GN tanısı alan 283 (159 erkek, 124 kadın, yaş ortalaması: 32.9±10, sınırlar: 15¬70) olgunun biyopsi sonuçlarının dağılımını incelediğimiz çalışmamızda en sık konulan tanıların: membranoproliferatif glomerülonefrit (MPGN) (% 26.6), membranöz glomerülonefrit (MGN) (%23.4) ve dijfüz proliferatif glomerülonefrit (DPGN) (%20.9) olduğu gözlendi. Biyopsi yapılan olguların %39.2 'sinde saf nefrotik sendrom, %30.4'ünde nefrotik+nefritik sendrom, %25.1 'inde ise nefritik sendrom kliniği gözlendi. Ayrıca olguların %5.3 'üne de asemptomatik idrar analizi bozukluğu nedeni ile biyopsi yapılmıştı. Nefrotik sendromlularda MPGN (%29.4), nefritik sendromlularda DPGN (%29.6), nefrotik+nefritik sendromlularda MPGN(%32.6) ve asemptomatik idrar analizi bozukluğu olanlarda ise DPGN (%33.3) en sık konulan tanılardı. Patogenezinde immun kompleks ile ilişkili mekanizmanın öngörüldüğü MPGN'nin gelişmiş ülkelerde son yıllarda önemli oranda gerilediği, bu durumun da enfeksiyonlardaki azalmayla açıklandığı bilinmektedir. Çalışmada bilinen sekonder nedenleri dışlamamıza karşın, MPGN'nin yüksek oranda bulunması ülkemiz şartlarında tanımlanamayan enfektif ajanların GN patogenezinde halen önemli rol oynadığını düşündürmektedir.
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