Renal Histopathology In Heroin Involved Deaths (An Autopsy Study)

Abstract

Objectives: To study /evaluate the histopathological changes in kidneys of dead bodies of heroin addicts, so to assess their involvement as possible cause of death. Study Design: Aprospective. observational study. Place & Duration: The work was completed in six months duration in the medicolegal departments of Abbasi Shaheed Hospital Karachi Jinnah Postgraduate Medical Center Karachi & Civil Hospital Karachi, and department of Pathology, Basic Medical Sciences Institute, JPMC Karachi. Material & Methods: Renal specimens were obtained from 25 autopsies of heroin addict persons autopsied in various hospitals of Karachi. Chemical analysis of lungs & kidneys was done in chemical lab for the detection of Morphine. All renal specimens were microscopically examined with Hernatoxylin-eosin, PAS, Congo red and Gomori (Methenamine silver trichrome).The stained slides were examined under microscope in the department of pathology. BMSI. JPMC, Karachi, All the findings were recorded on a proforma designed for the study and results were tabulated. Result: Out of 25 cases 12(48%) showed the features consistent with Mesangio-proliferativeglomerulo-nephritis, 3(12%) Membrano-prolifative glornerulonephritis (MPGN), 3(12%) with Progressive focal segmental glomerulosclerosis (FSGN). 3(12%) Focal segmental glomerulosclerosis. l (4%) with chronic granulomatous inflammation ( foreign body type), 1(4%) with diffuse glomeruloselerosis. 1 (4%) with Mesangial sclerosis and I (4%) showed vascular ectasia and congestion. Conclusion: Heroin addiction is associated with several severe and occasionally fatal renal complications. Mesangio-proliferativeglomentlo-nephritis and Membrano-prolifative glomerulo-nephritis (MPGN) and progressive FSGN are most common pathological findings in the syndrome of (HAN) Heroin associated nephropathy.