Histomorphological Spectrum of Glomerular Diseases: Diagnostic Contribution of Special Stains and Immunofluorescence

Background and Objectives: Renal biopsy interpretation requires correlation of clinical findings with structural alterations and immune-deposit patterns. This study was done with an objective to describe the histomorphological spectrum of glomerular diseases and separately assessed the additional diagnostic information provided by special stains and immunofluorescence (IF). Materials and Methods: This single-centre prospective descriptive study included 52 adequate renal biopsies received at Government Mohan Kumaramangalam Medical College and Hospital, Salem, between November 2019 and June 2021. Haematoxylin and eosin, periodic acid–Schiff and Jones methenamine silver stains were examined; IF findings were reviewed when tissue was available. Results were summarised descriptively. Results: Mean age was 31.06 ± 11.43 years; 29 patients (55.8%) were female. Primary glomerular diseases comprised 39 biopsies (75.0%), and secondary diseases 13 (25.0%). Minimal change disease was the commonest primary diagnosis (9/52, 17.3%), followed by IgA nephropathy and endocapillary proliferative glomerulonephritis (8/52 each, 15.4%). Lupus nephritis was the commonest secondary diagnosis (10/52, 19.2%). IF was performed in 44 cases (84.6%); in four cases (4/44, 9.1%) it contributed to a reported diagnostic refinement, including three IgA nephropathy cases and one class III lupus nephritis case. Conclusion: The biopsies demonstrated varied glomerular pathology. Special stains improved structural assessment, whereas IF added diagnostically relevant information in selected cases.