J Korean Soc Pediatr Nephrol.  2005 Apr;9(1):31-37.

A Histological and Clinical Study of the Children with Thin Glomerular Basement Membrane

• Kim YC
• Lee DW
• Cho MH
• Kwak JS
• Ko CW

Abstract

PURPOSE: Thin glomerular basement membrane disease(TGBMD) is found in patients with family history of hematuria. TGBMD is autosomal dominant and is known to be one of the commonest causes of asymptomatic hematuria. This study was conducted to evaluate the histological and clinical features of patients with TGBMD.
METHODS
150 cases diagnosed with TGBMD by renal biopsy while admitted in the department of pediatrics, Kyungpook National University Hospital between January 1999 and December 2003 comprised the study group. The following parameters were retrospectively analyzed:age of onset, hematuria pattern, existence of proteinuria, process of diagnosis, laboratory findings, thickness and character of basement membrane and family history.
RESULTS
The mean age at the time of diagnosis was 7.9 years. The male to female ratio was 65:77. 94 patients or 66% visited the hospital with a chief complaint of persistent microscopic hematuria. Gross hematuria accounted for 13 cases or 9%. 78 cases(55%) were found to have hematuria for the first time from a routine school urinalysis screening. The renal biopsy showed the thickness of basement membrane to be 186+/-36 nm. Focal lamellation of the basement membrane was found in eight cases. In the family history, hematuria was shown in 10 cases on the paternal side, 13 on the maternal side and none on both sides. In seven cases, hematuria was shown among siblings. No significant differences were found among the laboratory test results which were conducted at an average interval of fifteen months.
CONCLUSION
TGBMD is one of the major causes of asymptomatic hematuria in children, which was diagnosed in increasing numbers since school urinary mass screening test started in 1998. In cases with familial progressive renal disease or focal duplication in the basement membrane Alport syndrome should be considered.

Keyword

Thin glomerular basement membrane disease; Asymptomatic hematuria; Alport syndrome

MeSH Terms

Basement Membrane
Biopsy
Child*
Clinical Laboratory Techniques
Diagnosis
Female
Glomerular Basement Membrane*
Gyeongsangbuk-do
Hematuria
Humans
Male
Mass Screening
Nephritis, Hereditary
Pediatrics
Proteinuria
Retrospective Studies
Siblings
Urinalysis