THE EFFECT ON PATIENT-MANAGEMENT OF TEMPORARY NON-AVAILABILITY OF IMMUNOFLUORESCENCE FOR RENAL BIOPSY REPORTING

Delay in reporting the immunofluorescence findings on renal biopsies, owing to an interruption in supply of reagents, made possible a retros pective analysis of the effect of the lack of this information on pati ent management. Hospital case records of the 39 patients so affected w ere reviewed to determine what changes in their management took place after the immunofluorescence findings became available. The clinical, laboratory, and light microscopic findings in all except a case of pau ci-immune crescentic glomerulonephritis allowed management decisions t o be made that were not influenced by immunofluorescence findings. Thi s was owing to correct prediction of the immunofluorescence findings, as in cases of IgA nephropathy presenting with recurrent haematuria; t he adequacy of light microscopy in the interpretation of graft biopsie s, in classifying lupus nephritis and in most cases of nephrotic syndr ome; and the absence of entities identifiable only by immunofluorescen ce among these patients.