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Paul M, Addya S, Sengupta M, Basu K, Roychowdhury A, Bandopadhyay M. Spectrum of renal vascular lesions among patients with lupus nephritis: An experience from a tertiary care center. INDIAN J PATHOL MICR 2023; 66:751-757. [PMID: 38084527 DOI: 10.4103/ijpm.ijpm_327_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Lupus nephritis (LN) is the assemblage of glomerular, tubulointerstitial and vascular changes. Despite the fact that glomerular changes are overemphasized in pathological classification and scoring system, but the existence of vascular damage negatively impact the clinical course. Aims and Objective This study was conducted to determine the clinicopathological spectrum of renal vascular lesions in lupus nephritis. Materials and Methods Renal microvascular lesions in biopsy proven lupus nephritis were classified into 5 major categories-thrombotic microangiopathy, true vasculitis; lupus vasculopathy, uncomplicated vascular immune deposits, and arterial. Clinical details, laboratory parameters and histopathological variables were compared among all groups. Summary of chronic changes was also assessed. Results Biopsies from 56 patients revealed thrombotic microangiopathy (2), lupus vasculopathy (3), uncomplicated vascular immune deposit (6), PAN type vasculitis (1) and arterial sclerosis (13). No renal vascular lesions were found in 35.18% of patients. At the time of biopsy, arterial sclerosis or lupus vasculopathy patients were older Nephritis subtype. Activity indices were higher in lupus vasculopathy group whereas patients with arteriosclerosis showed highest chronicity index. Conclusions Renal vascular lesions are common in systemic lupus erythematosus patients with nephritis and may be associated with aggressive clinical course.
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Affiliation(s)
- Madhumita Paul
- Department of Pathology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| | - Soma Addya
- Department of Pathology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
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Mukherjee S, Kumar A, Maity P, Sengupta M, Basu K, Chaudhury AR, Bandopadhyay M, Chakraborty BC. Utility of serum anti-phospholipase A2 receptor antibody as a biomarker in membranous nephropathy: An experience from a tertiary care center of Eastern India. INDIAN J PATHOL MICR 2023; 66:269-277. [PMID: 37077067 DOI: 10.4103/ijpm.ijpm_210_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
Background Membranous nephropathy (MN) is a pattern of glomerular injury. Exact categorization into primary membranous nephropathy (PMN) or secondary membranous nephropathy (SMN) is essential for treatment. An endogenous podocyte antigen, M-type phospholipase A2 receptor (PLA2R) has been discovered to be involved in the pathogenesis of PMN. Aims and Objectives In this article, we aimed to analyze renal tissue PLA2R and serum anti-PLA2R antibodies in MN cases and determined the diagnostic utility. Materials and Methods The study was of prospective type carried out from March 2019 to August 2020. Analysis of cases of MN was performed with PLA2R paraffin immunoflourescence and serum anti-PLA2R antibody ELISA. Results Overall sensitivity, specificity, PPV, and NPV of serum anti-PLA2R ELISA for PMN was 91.3%, 80%, 75%, and 93.3%, respectively, and of tissue PLA2R staining for PMN was 91.67%, 81.08%, 75.86%, and 93.75%, respectively. There was strong concordance between two methods. In the patients that were followed up, we found baseline serum anti-PLA2R antibody was less in complete remission group than that in non-remission group and the reduction in serum anti-PLA2R antibody was more in complete remission group than that in non-remission group. Conclusion Routine light and immunofluorescence examination are incapable of giving exact categorical opinion regarding PMN and SMN. Serum anti-PLA2R antibody detection and renal tissue PLA2R analysis are sensitive and specific in detecting PMN. Baseline serum anti-PLA2R antibody and anti-PLA2R antibody quantification trends are related to prognosis of PMN. So they can be incorporated as additional biomarker.
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Affiliation(s)
- Sriranjan Mukherjee
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Abhishek Kumar
- Department of Nephrology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Priyanka Maity
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | | | - Manimoy Bandopadhyay
- Director, Department of Anatomy, Reasearch Scientist - I, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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Srivastava SR, Sarkar P, Ganguly P, Mukherjee D, Ray BK, Dubey S, Pandit A, Sengupta A, Bandopadhyay M, Ghosh AK, Poddar KG, Guha S, Ayub A. Central Retinal Artery Occlusion in COVID-Associated Mucormycosis. J Glob Infect Dis 2023; 15:66-71. [PMID: 37469471 PMCID: PMC10353642 DOI: 10.4103/jgid.jgid_185_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/24/2022] [Accepted: 02/02/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction Significant surge of mucormycosis was reported in the Indian Subcontinent during the second wave of the COVID-19 pandemic. COVID-associated mucormycosis (CAM) was defined as the development of features of mucormycosis with prior or current history of COVID-19 infection. Rapid angioinvasion is an important characteristic of mucormycosis. Authors intended to find out the prevalence of retinal arterial occlusion and its association with vascular embolic occlusion elsewhere in the body among CAM patients in this study. Methods This was an observational study. All consecutive-confirmed cases of mucormycosis (n = 89) and age-/gender-/risk factor-matched controls (n = 324) admitted in the designated COVID center were included in the study. All cases and controls underwent comprehensive ophthalmological, otorhinological, and neurological examinations. All necessary investigations to support the clinical diagnosis were done. Qualitative data were analyzed using the Chi-square test. Quantitative data for comparison of means between the cases and controls were done using unpaired t-test. Results Twenty-one (23.59%) patients manifested the defined outcome of central retinal artery occlusion (CRAO). Among age-matched control, with similar diabetic status, none had developed the final outcome as defined (P < 0.05). About 90.47% of subjects with CRAO presented with no perception of light vision. Thirteen subjects (61.9%) with the final outcome developed clinical manifestations of stroke during the course of their illness with radiological evidence of watershed infarction (P = 0.001). Orbital debridement was performed in 9 (42.85%) subjects while orbital exenteration was done in 8 (38.09%) subjects. Conclusions CRAO in CAM patients was found to have aggressive nature turning the eye blind in a very short period of time. CRAO can serve as a harbinger for subsequent development of more debilitating and life-threatening conditions such as stroke among CAM patients.
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Affiliation(s)
| | - Peyalee Sarkar
- Department of Neurology, Bangur Institute of Neurosciences, IPGME and R and SSKMH, Kolkata, West Bengal, India
| | - Purban Ganguly
- Division of Orbit and Oculoplasty, Regional Institute of Ophthalmology, Kolkata, West Bengal, India
| | - Debaleena Mukherjee
- Department of Neuromedicine, Bangur Institute of Neurosciences, IPGME and R and SSKMH, Kolkata, West Bengal, India
| | - Biman Kanti Ray
- Department of Neuromedicine, Bangur Institute of Neurosciences, IPGME and R and SSKMH, Kolkata, West Bengal, India
| | - Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences, IPGME and R and SSKMH, Kolkata, West Bengal, India
| | - Alak Pandit
- Department of Neuromedicine, Bangur Institute of Neurosciences, IPGME and R and SSKMH, Kolkata, West Bengal, India
| | - Amitabh Sengupta
- Department of Pulmonary Medicine, IPGME and R and SSKMH, Kolkata, West Bengal, India
| | | | - Asim Kumar Ghosh
- Regional Institute of Ophthalmology, Kolkata, West Bengal, India
| | | | - Soumyajit Guha
- Department of Ophthalmology, IPGME and R and SSKMH, Kolkata, West Bengal, India
| | - Asif Ayub
- Regional Institute of Ophthalmology, Kolkata, West Bengal, India
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Basu K, Sengupta M, Mukherjee S, Karmakar S, Roychowdhury A, Bandopadhyay M. Role of light and immunofluorescence microscopy to differentiate primary and secondary membranous nephropathy. INDIAN J PATHOL MICR 2022; 65:821-827. [PMID: 36308187 DOI: 10.4103/ijpm.ijpm_22_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
CONTEXT Membranous nephropathy (MN) causes nephrotic syndrome, mostly primary but may be associated with SLE, infections, cancer, or drug. AIMS To estimate clinical, serological, light microscopic, and direct immunofluorescence (DIF) findings to differentiate primary and secondary MN. SETTINGS AND DESIGN Prospective, cross-sectional, single-center study in a tertiary care hospital. METHODS AND MATERIAL Total 51 cases from September 2019 to February 2020. LABORATORY DATA Blood glucose, urine analysis, urea, creatinine, albumin, cholesterol, HBsAg, Anti HCV, ASO, ANA, MPO ANCA, PR3 ANCA, dsDNA, PLA2R, C3, and C4. Clinical parameters: age, sex, BP, skin lesions, arthralgia, edema, obesity. Renal biopsies examined with H and E, PAS, silver methanamine, MT stains. DIF done with IgG, IgM, IgA, C3c, C1q, kappa, and lambda. STATISTICAL ANALYSIS USED Statistical software (Graph Pad PRISM 6) and Chi-square test). RESULTS Among 51 cases, 25 are primary and 26 are secondary MN with 22 being lupus nephritis, with 2 being post-infectious and the remaining 2 being proliferative glomerulonephritis with monoclonal immunoglobulin deposition (PGNMIDD) with kappa chain restriction. Mean age was 37 ± 12.18 and 30.69 ± 13.92 years for primary and secondary MN, respectively. Significant male preponderance in primary MN. Serum C4 significantly low in secondary MN (15.34 ± 9.59). Microscopic hematuria present in secondary MN. Mesangial and endocapillary hypercellularity are significant in secondary MN. IgG and kappa are significantly intense in primary whereas IgA, C3c, and C1q are significantly intense in secondary MN. CONCLUSIONS Reliable differentiation between primary and secondary MN has important therapeutic implications.
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Affiliation(s)
- Keya Basu
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Health University, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Health University, Kolkata, West Bengal, India
| | - Sriranjan Mukherjee
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Health University, Kolkata, West Bengal, India
| | - Subhrajyoti Karmakar
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Health University, Kolkata, West Bengal, India
| | - Arpita Roychowdhury
- Department of Pathology, Institute of Postgraduate Medical Education and Research, Health University, Kolkata, West Bengal, India
| | - Manimoy Bandopadhyay
- Department of Nephrology, Institute of Postgraduate Medical Education and Research, Health University, Kolkata, West Bengal, India
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Basu K, Addya S, Mukherjee S, Sengupta M, Pandey R, Chatterjee G, Bandopadhyay M. Clinicopathological Spectrum of Henoch-Schönlein Purpura Vasculitis: An Experience from a Tertiary Care Center. Saudi J Kidney Dis Transpl 2022; 33:693-701. [PMID: 37955461 DOI: 10.4103/1319-2442.389429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Henoch-Schönlein purpura (HSP) is a small vessel vasculitis with multiorgan involvement. Renal involvement is the key factor predicting morbidity. We have aimed to analyze the clinicopathological spectrum of HSP vasculitis and HSP nephritis to assess the risk factors associated with kidney involvement. This retrospective study was performed in the department of pathology with collaboration of department of dermatology and department of nephrology of a tertiary care center. All clinical details along with biopsy findings were retrieved. Starting materials of the study were cases of leukocytoclastic vasculitis with only perivascular IgA deposit of more than ++ in the absence of other immunoglobulin and trace complements. To investigate the possible factors that are influential on the development of biopsy-proven HSP nephritis, we divided the whole study population in two groups -group 1: with and group 2: without biopsy-proven nephritis. One-way analysis of variance was carried out during comparative analysis between two groups using IBM SPSS statistics software, version 19 and MedCalc software, version 12.3.0.0. HSP vasculitis comprised 11.6% (n = 19) of total cutaneous vasculitis in 2 years (164 cases) with a mean age of 13.52 ± 8.10 (range: 4-33 years). Three cases developed de novo kidney disease (15.79%). A correlation analysis revealed that predictors were seasonal variation (P = 0.018), severe gastrointestinal involvement (P = 0.03), and subcutaneous edema (P = 0.005). Various clinical and laboratory parameters were associated with renal consequences. Occult nephritis was the most common presentation with crescent as a constant histopathological feature.
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Affiliation(s)
- Keya Basu
- Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Soma Addya
- Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Sriranjan Mukherjee
- Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Rajendra Pandey
- Department of Nephrology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Manimoy Bandopadhyay
- Department of Anatomy, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
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Basu K, Karmakar S, Sengupta M, Addya S, Chatterjee G, Bandopadhyay M. Cutaneous Vesiculobullous Lesions: A Clinicopathologic Study. Skinmed 2022; 20:35-46. [PMID: 35435824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Vesiculobullous disorders could be either immunobullous or non-immunobullous. The spectrum was analyzed using histopathology, direct immunofluorescence (DIF), and salt-split technique. Among the 104 patients analyzed, 77 (74%) were immunobullous and 25 (24%) were having non-immunobullous diseases. Bullous pemphigoid (20.2%) is the commonest among immunobullous lesions, and epidermolysis bullosa (11.5%) was the most frequent non-immunobullous lesion. Involvement of the hair and nail and a positive family history were common relationships for non-immunobullous disorders. Immunobullous lesions showed DIF positivity whereas non-immunobullous lesions were DIF negative. Perilesional DIF was more sensitive and specific than lesional DIF. The commonest antibody was immunoglobulin G (IgG) (78.9%) followed by complement 3c (C3c) (38.1%), immunoglobulin A (IgA) (25%), and immunoglobulin M (IgM) (6.6%). No lesion should be considered non-immunobullous unless both lesional and perilesional DIF results were negative.
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Affiliation(s)
- Keya Basu
- Department of Pathology and Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, India;
| | - Subhrajyoti Karmakar
- Department of Pathology and Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Moumita Sengupta
- Department of Pathology and Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Soma Addya
- Department of Pathology and Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Gobindo Chatterjee
- Department of Pathology and Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Manimoy Bandopadhyay
- Department of Pathology and Dermatology, Institute of Postgraduate Medical Education and Research, Kolkata, India
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Dubey S, Mukherjee D, Sarkar P, Mukhopadhyay P, Barman D, Bandopadhyay M, Pandit A, Sengupta A, Das S, Ghosh S, Adhikari S, Biswas PS, Pal P, Roy H, Patra N, Das A, Sinha P, Mondal MK, Shrivastava SR, Bhattacharya K, Mukhopadhyay M, Ahmed K, Halder TK, Saha M, Ahmed K, Maity S, Mandal A, Chatterjee D, Saha S, Chunakar A, Saha A, Ray BK. COVID-19 associated rhino-orbital-cerebral mucormycosis: An observational study from Eastern India, with special emphasis on neurological spectrum. Diabetes Metab Syndr 2021; 15:102267. [PMID: 34509790 PMCID: PMC8407938 DOI: 10.1016/j.dsx.2021.102267] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 07/28/2021] [Accepted: 08/30/2021] [Indexed: 12/30/2022]
Abstract
AIMS 1: Describe the epidemiology and determine risk factors for COVID-19 associated mucormycosis. 2: Elaborate the clinical spectrum of Rhino-Orbital-Cerebral Mucormycosis (ROCM), pattern of neuroaxis involvement and it's radiological correlates. METHODS Observational study. Consecutive, confirmed cases of mucormycosis (N = 55) were included. A case of mucormycosis was defined as one who had clinical and radiological features consistent with mucormycosis along with demonstration of the fungus in tissue via KOH mount/culture/histopathological examination (HPE). Data pertaining to epidemiology, risk factors, clinico-radiological features were analysed using percentage of total cases. RESULTS Middle aged, diabetic males with recent COVID-19 infection were most affected. New onset upper jaw toothache was a striking observation in several cases. Among neurological manifestations headache, proptosis, vision loss, extraocular movement restriction; cavernous sinus, meningeal and parenchymal involvement were common. Stroke in ROCM followed a definitive pattern with watershed infarction. CONCLUSIONS New onset upper jaw toothache and loosening of teeth should prompt an immediate search for mucormycosis in backdrop of diabetic patients with recent COVID-19 disease, aiding earlier diagnosis and treatment initiation. Neuroaxis involvement was characterized by a multitude of features pertaining to involvement of optic nerve, extraocular muscles, meninges, brain parenchyma and internal carotid artery.
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Jain K, Sengupta M, Basu K, Chowdhury AR, Bandopadhyay M. Sudden renal failure in a case of overlap connective tissue disorder-A diagnostic dilemma. INDIAN J PATHOL MICR 2021; 64:217-219. [PMID: 33433452 DOI: 10.4103/ijpm.ijpm_740_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kavita Jain
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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Basu K, Karmakar S, Sengupta M, Roychowdhury A, Ghosh A, Bandopadhyay M. Pediatric lupus nephritis - An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern India. INDIAN J PATHOL MICR 2021; 63:397-404. [PMID: 32769328 DOI: 10.4103/ijpm.ijpm_995_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Systemic lupus erythematosus is an autoimmune multisystem disease with a high predilection for renal involvement. Lupus nephritis develops in 20% to 75% within the first two years. Presentation varies from subnephrotic proteinuria to end-stage renal disease. Aims To study clinical features, biochemical, and serological parameters and correlate with histological activity and chronicity score [modified National Institute of Health (NIH) score]. Settings and Design Retrospective, cross-sectional, single-center based study in a tertiary care hospital of Eastern India. Subjects and Methods We incuded 36 children with lupus nephritis diagnosed from February 2018 to March 2019. Laboratory data included were complete blood count (CBC), blood glucose, urine analysis, serum urea, creatinine, blood urea nitrogen (BUN), albumin, cholesterol, HBsAg, antihepatitis C virus (HCV) antibody, antistreptolysin O (ASO) titer, antinuclear antibody (ANA), myeloperoxidase antineutrophil cytoplasmic antibody (MPO ANCA), proteinase 3 antineutrophil cytoplasmic antibody (PR3 ANCA), double-stranded DNA (dsDNA), C3, and C4. Clinical parameters were age, sex, blood pressure (BP), skin lesions, arthralgia, edema, obesity. Renal biopsies examined with light microscopy, hematoxylin and eosin (H and E), periodic acid-Schiff (PAS), silver methanamine, Masson's trichrome (MT) stains. Immunofluorescence microscopy done with IgG, IgM, IgA, C3c, C1q, kappa, lambda antibodies. Statistical Analysis Used Kruskal-Wallis and χ2 tests. Results Mean age was 15.12 ± 3.49 and 12.5 ± 1.73 years for lupus nephritis (LN) with activity and LN without activity, respectively. Mean dsDNA was higher and mean C3 was lower (52.35 ± 22.21 mg/dl) in active LN. Mean 24-hour urinary protein was higher in LN without activity. Serum creatinine was raised in active LN. LN class III and IV showed higher activity than chronicity. Conclusions Pediatric LN is proliferative and more active as compared with adult counterparts. Activity scores are much higher than chronicity scores.
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Affiliation(s)
- Keya Basu
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Subhrajyoti Karmakar
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Arpita Roychowdhury
- Department of Nephrology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Alakendu Ghosh
- Department of Rheumatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Manimoy Bandopadhyay
- Director, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Karmakar S, Basu K, Sengupta M, Chatterjee G, Sarkar S, Bandopadhyay M. Genetic and acquired blistering disorders of pediatric age group: An experience from Eastern India. INDIAN J PATHOL MICR 2021; 64:509-517. [PMID: 34341262 DOI: 10.4103/ijpm.ijpm_314_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Blistering or vesiculobullous disorders in pediatric population are either immunobullous or mechanobullous. Spectrum was analyzed using demographic details, clinical features, histopathology, direct immunofluorescence (DIF) and Immunofluorescence mapping (IFM). Methodology This was a single institution based observational study in children below 18 years. The demographic details were collected using proforma containing particulars of the patient, history, complaints, and other parameters. Punch biopsy of the skin lesion was done. Biopsy samples were examined under light microscope followed by DIF using fluorescent conjugated polyclonal antibody against immunoglobulins IgG, IgM, IgA, and complement C3. The salt-split technique was also used in particular cases. IFM was done using anticytokeratin (CK) 5 & 14, antilaminin 332, anticollagen VII, and anticollagen IV antibodies. Results Out of total 50 cases, linear IgA bullous dermatosis (LABD) was the commonest. The average concordance between clinical and final diagnosis (histopathological examination + DIF) was 87.5% and discordance was 12.5%. The agreement between histopathological examination and DIF was found to be substantially significant (κ = 0.6892). IFM depicted epidermolysis bullosa simplex with reduced CK 14 expression, dystrophic epidermolysis bullosa with reduced Collagen VII expression and junctional epidermolysis bullosa with absent laminin 5 expression. Conclusion The spectrum of bullous lesions in childhood was properly delineated and subcategorization of EB was done. Histopathological examination showed the hallmarks that were conclusive in most of the cases except in LABD and EB. DIF and IFM proved indispensable in those cases. Thus, DIF is not a substitute for histopathology but complementary to it.
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Affiliation(s)
- Subhrojyoti Karmakar
- Department of Pathology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Gobinda Chatterjee
- Department of Dermatology, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Sumantra Sarkar
- Department of Pediatric Medicine, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
| | - Manimoy Bandopadhyay
- Department of Anatomy, Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India
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Abstract
IgG4-related disease (IgG4-RD) is an evolving entity characterized by immune mediated multisystem involvement in the form of fibro inflammatory lesions like sclerosing pancreatitis, dacryoadenitis, Reidel thyroiditis, or chronic sclerosing sialadenitis. Barely, the lesions are restricted to kidney (IgG4-RKD: IgG4-related kidney disease) involving either glomerular or extraglomerular compartment. It is challenging to identify and demands an awareness regarding the entity to reduce the number misdiagnosis and missed diagnosis. Here, we report a case of a 45-year-old woman with IgG4 tubulointerstitial nephritis (IgG4-TIN) who presented with unexplained renal dysfunction as her initial manifestation. This is the first case of IgG4-RKD reported from our tertiary care center among 1864 native renal biopsy in the last two years.
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Affiliation(s)
- Kavita Jain
- Department of Pathology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
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Das R, Dutta S, Roy B, Mandal S, Sahu S, Bandopadhyay M, Paul K, Ghosh S. Spectrum of Echocardiographic Findings in Coronavirus Disease-2019 Patients. J Indian Acad Echocardiogr Cardiovasc Imaging 2021. [DOI: 10.4103/jiae.jiae_18_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sengupta M, Dasgupta S, Basu K, Mukherjee S, Sarkar S, Chowdhury AR, Pandey R, Bandopadhyay M. A tale of tripartite: An experience from a tertiary care center of Eastern India. INDIAN J PATHOL MICR 2021; 64:497-503. [PMID: 34341260 DOI: 10.4103/ijpm.ijpm_445_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Crescentic glomerulonephritis (Cr GN) is pattern of glomerular injury resulting from wide range of diseases sharing a common pathogenesis. Objectives The objective of our study was to analyze the clinicopathological spectrum and outcome of Cr GN with special reference to its immunopathological subtypes using a panel of immunofluorescence stains. Materials and Methods Native renal biopsies with crescentic pattern of injury were included. Detailed Clinical and laboratory variables were analyzed along with the treatment protocol and renal outcome, wherever available. Renal biopsy slides were evaluated for various glomerular and extraglomerular features. Both qualitative and quantitative data were analyzed. Results A total of 57 cases of Cr GN were included; majority (47.36%) of cases were pauci-immune in nature. Among clinical features, ranges of proteinuria and creatinine level were significantly different between subgroups. The various light microscopic parameters, including proportion of cellular crescents and capillary wall necrosis were different. Presence of arteriolar changes also showed association with unfavorable outcome. Three unusual associations, including IgA nephropathy, membranous glomerulonephritis and Hepatitis B infection were detected. Adequate follow-up information was available in 35 of the patients. Of these, 14 were dialysis-dependent at the last follow-up. Conclusions Type III Cr GN (pauci-immune Cr GN) was the commonest cause of Cr GN in our population. Adult patients required renal replacement therapy more frequently than pediatric cases those are chiefly infection associated. Critical appraisal of clinical, histopathological and immunofluorescence finding help to identify individual subtypes as treatment and outcome varies accordingly.
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Affiliation(s)
- Moumita Sengupta
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Saugat Dasgupta
- Department of Nephrology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Sriranjan Mukherjee
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Sucharita Sarkar
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | | | - Rajendra Pandey
- Department of Nephrology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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Karmakar S, Basu K, Sengupta M, Roychowdhury A, Pandey R, Bandopadhyay M. Membranoproliferative Glomerulonephritis- A Disease or a Pattern of Injury? J Clin Diagn Res 2020. [DOI: 10.7860/jcdr/2020/45206.14257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction:Membranoproliferative Glomerulonephritis (MPGN) is a pattern of glomerular injury resulting from wide range of diseases sharing a common pathogenesis and thus, presented with large spectrum of clinical presentation starting from slowly progressive subnephrotic range proteinuria to nephritic syndrome and Rapidly Progressive Glomerulonephritis (RPGN). Aim: The aim of the study was to do reanalysis of the aetiological classification of MPGN and its prognostic outcomes. Materials and Methods: A retrospective, cohort study was conducted including the patients of all age groups with MPGN pattern of injury, from February, 2018 to August, 2018 at a Tertiary Healthcare Centre of West Bengal, India. All specimens were examined by two nephropathologists at the institute using both light microscope and immunofluorescence microscope. Haematoxylin and Eosin (H&E), Periodic Acid-Schiff (PAS), silver methanamine, Masson’s Trichrome (MT) stained smears were prepared for light microscopy. Specimens for immunofluorescence microscopy were stained using Fluorescein Isothiocyanate (FITC) conjugated polyclonal rabbit anti-sera against human IgG, IgM, IgA, C3, C1q, kappa, lambda. Correlations were evaluated using Spearman’s rank correlation. A p<0.05 was considered as statistically significant. GRAPHPAD PRISM 5 was used for statistical analysis. Results: From a total of 47 cases, 41 cases in immunoglobulin associated group, 4 cases in C3 nephropathy group and 2 cases in pauci-immune group were found. Autoimmune diseases had the strongest association followed by infections and dysproteinemia. Severity and chronicity parameters were more prevalent in the immunoglobulin positive group. The pauci-immune group showed maximum vascular involvement, indicating it to arise from a vascular pathology. Conclusion: Membranoproliferative Glomerulonephritis is not a single disease entity instead this pattern of injury could be seen in a variety of diseased condition.
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Sarkar N, Panigrahi R, Pal A, Biswas A, Singh SP, Kar SK, Bandopadhyay M, Das D, Saha D, Kanda T, Sugiyama M, Chakrabarti S, Banerjee A, Chakravarty R. Expression of microRNA-155 correlates positively with the expression of Toll-like receptor 7 and modulates hepatitis B virus via C/EBP-β in hepatocytes. J Viral Hepat 2015; 22:817-27. [PMID: 25720442 DOI: 10.1111/jvh.12390] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 11/15/2014] [Indexed: 12/11/2022]
Abstract
Effective recognition of viral infection and successive activation of antiviral innate immune responses are vital for host antiviral defence, which largely depends on multiple regulators, including Toll-like receptors (TLRs) and microRNAs. Several early reports suggest that specific TLR-mediated immune responses can control hepatitis B virus (HBV) replication and express differentially with disease outcome. Considering the versatile function of miR-155 in the TLR-mediated innate immune response, we aimed to study the association between miR-155 and TLRs and their subsequent impact on HBV replication using both a HBV-replicating stable cell line (HepG2.2.15) and HBV-infected liver biopsy and serum samples. Our results showed that miR-155 was suppressed during HBV infection and a subsequent positive correlation of miR-155 with TLR7 activation was noted. Further, ectopic expression of miR-155 in vitro reduced HBV load as evidenced from reduced viral DNA, mRNA and subsequently reduced level of secreted viral antigens (HBsAg and HBeAg). Our results further suggested that CCAAT/enhancer-binding protein-β (C/EBP-β), a positive regulator of HBV transcription, was inhibited by miR-155. Taken together, our study established a correlation between miR-155 and TLR7 during HBV infection and also demonstrated in vitro that increased miR-155 level could help to reduce HBV viral load by targeting C/EBP-β.
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Affiliation(s)
- N Sarkar
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
| | - R Panigrahi
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
| | - A Pal
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
| | - A Biswas
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
| | - S P Singh
- Department of Gastroenterology, SCB Medical College, Cuttack, India.,Kalinga Gastroenterology Foundation, Beam Diagnostics Premises, Cuttack, India
| | - S K Kar
- Department of Gastroenterology, SCB Medical College, Cuttack, India
| | - M Bandopadhyay
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
| | - D Das
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
| | - D Saha
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
| | - T Kanda
- Department of Medicine and Clinical Oncology, Chiba University, Graduate School of Medicine, Chiba, Japan
| | - M Sugiyama
- National Center for Global Health and Medicine (NCGM), Ichikawa, Japan
| | - S Chakrabarti
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India.,National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - A Banerjee
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
| | - R Chakravarty
- ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, Kolkata, India
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Bandopadhyay M, Ganguly AK. Putrescine, DNA, RNA and protein contents in human uterine, breast and rectal cancer. J Postgrad Med 2000; 46:172-5. [PMID: 11298463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
AIMS To find out the status of DNA, RNA and protein in human uterine, ovarian, breast and rectal carcinoma. MATERIAL AND METHODS In this prospective study, patients of age group between late thirties and late fifties suffering from uterine, ovarian, breast and rectal cancer were taken as subjects of the present study. The total number of cases studied for each cases was ten. Pieces of human carcinomatous tissues of above mentioned cases were taken along with surrounding normal tissues. From the tissue samples, putrescine is separated by the method of Herbst et al, DNA analysed by Diphenylamine method, RNA by Orcinol method and protein by Biuret method. RESULTS Tissue content of putrescine rises simultaneously with that of DNA, RNA and protein in carcinomatous growths as above in comparison to their respective adjacent normal tissue, the differences being statistically highly significant. CONCLUSIONS Increase in DNA, RNA and protein concentration may be a pre-requisite for increased synthesis of putrescine in carcinomatous tissue and thereby the concentration of other di- and poly-amines.
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Affiliation(s)
- M Bandopadhyay
- Department of Medicine, University College of Medicine, Dr. B. C. Roy Postgraduate Institute of Basic Medical Sciences, Calcutta-700 020, India
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Chinnakali K, Fun HK, Mal D, Bandopadhyay M, Datta K, Nigam GD. 5a,6,9,9a-Tetrahydro-4-hydroxy-6,9-methano-5 H-fluoreno[2,3- b]furan-5-one and 5a,6,9,9a-tetrahydro-6,9-methano-4-methoxy-5 H-fluoreno[2,3- b]furan-5-ol. Acta Crystallogr C 1999. [DOI: 10.1107/s0108270199001596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Das Gupta T, Bandyopadhyag T, Dastidar SG, Bandopadhyay M, Mitra A, Chakrabarty AN. R plasmids of Staphylococcus & their elimination by different agents. Indian J Exp Biol 1980; 18:478-81. [PMID: 7429562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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