ISSN: 2642-6145
Authors: Varma R and Srinivas BH*
Context: The Immunofluorescence technique is considered gold standard in the diagnosis of lupus nephritis. Special stains like Periodic Schiff-Methenamine stain (PASM) and Masson’s Trichrome (MT), which are more easily accessible, are hypothesized to have an accuracy similar to Immunofluorescence in diagnosing lupus nephritis. Aims: The aim of this study is to assess the diagnostic accuracy of Periodic Schiff-Methenamine stain (PASM) and Masson’s Trichrome (MT) stains for immune complex deposits in lupus nephritis. Settings and Design: The study was conducted in a laboratory environment. Renal biopsy samples, which showed full-house deposits on Immunofluorescence were considered. The corresponding biopsy slides were further studied under a light microscope using special stains like PASM and MT. Methods and Material: Fuchsinophilic (red) deposits in the glomeruli were identified as sub-endothelial, sub-epithelial and mesangial deposits under the light microscope and were used to classify lupus nephritis as per the ISN/RPS classification. Statistical analysis used: Diagnostic accuracy study was carried out and the degree of agreement between special stains and Immunofluorescence was expressed as frequencies and percentages. Results: 86.84% of the sample showed agreement between special stains (PASM and MT) and Immunofluorescence. This was most evident in class III and IV lupus nephritis cases with 96.42% agreement. Conclusion: Special stains like PASM and MT were accurate enough to be used in resource limited areas, where Immunofluorescence is not readily available.
Keywords: Immunofluorescence; Periodic Schiff-Methenamine Stain; Lupus Nephritis; Masson’s Trichrome
