Cargando…

Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report

INTRODUCTION: Some cases of membranous nephropathy (MGN) present focal segmental glomerulosclerosis (FSGS) typically associated with disease progression. However, we report a case of a patient who seemed to have MGN and FSGS, both primary. CASE PRESENTATION: A 17-year-old female, Caucasian, presenti...

Descripción completa

Detalles Bibliográficos
Autores principales: da Silva, Crislaine Aparecida, Custódio, Fabiano Bichuette, Monteiro, Maria Luíza Gonçalves dos Reis, Araújo, Stanley de Almeida, Araújo, Liliane Silvano, Côrrea, Rosana Rosa Miranda, dos Reis, Marlene Antônia, Machado, Juliana Reis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Nefrologia 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213925/
https://www.ncbi.nlm.nih.gov/pubmed/30806447
http://dx.doi.org/10.1590/2175-8239-JBN-2018-0239
_version_ 1783531881049882624
author da Silva, Crislaine Aparecida
Custódio, Fabiano Bichuette
Monteiro, Maria Luíza Gonçalves dos Reis
Araújo, Stanley de Almeida
Araújo, Liliane Silvano
Côrrea, Rosana Rosa Miranda
dos Reis, Marlene Antônia
Machado, Juliana Reis
author_facet da Silva, Crislaine Aparecida
Custódio, Fabiano Bichuette
Monteiro, Maria Luíza Gonçalves dos Reis
Araújo, Stanley de Almeida
Araújo, Liliane Silvano
Côrrea, Rosana Rosa Miranda
dos Reis, Marlene Antônia
Machado, Juliana Reis
author_sort da Silva, Crislaine Aparecida
collection PubMed
description INTRODUCTION: Some cases of membranous nephropathy (MGN) present focal segmental glomerulosclerosis (FSGS) typically associated with disease progression. However, we report a case of a patient who seemed to have MGN and FSGS, both primary. CASE PRESENTATION: A 17-year-old female, Caucasian, presenting lower extremity edema associated with episodes of foamy urine and high blood pressure, had physical and laboratorial exams indicating nephrotic syndrome. A renal biopsy was performed and focal and segmental glomerulosclerosis were observed under light microscopy in some glomeruli presented as tip lesion, and in others it was accompanied by podocyte hypertrophy and podocyte detachment in urinary space, compatible with podocytopathy FSGS. Besides, there were thickened capillary loops with basement membrane irregularities due to "spikes" compatible with MGN stage II. Immunofluorescence showed finely granular IgG, IgG4, and PLA2R deposits in capillary loops and, in electron microscopy, subepithelial deposits and foot process effacement. These morphological findings are compatible with FSGS and MGN stage II. CONCLUSIONS: In the present case, clinical and morphological characteristics showed a possible overlap of primary FSGS and MGN as focal and segmental glomerulosclerosis does not seem to be related with MGN progression but with the podocytopathy FSGS.
format Online
Article
Text
id pubmed-7213925
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Sociedade Brasileira de Nefrologia
record_format MEDLINE/PubMed
spelling pubmed-72139252020-05-13 Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report da Silva, Crislaine Aparecida Custódio, Fabiano Bichuette Monteiro, Maria Luíza Gonçalves dos Reis Araújo, Stanley de Almeida Araújo, Liliane Silvano Côrrea, Rosana Rosa Miranda dos Reis, Marlene Antônia Machado, Juliana Reis J Bras Nefrol Case Report INTRODUCTION: Some cases of membranous nephropathy (MGN) present focal segmental glomerulosclerosis (FSGS) typically associated with disease progression. However, we report a case of a patient who seemed to have MGN and FSGS, both primary. CASE PRESENTATION: A 17-year-old female, Caucasian, presenting lower extremity edema associated with episodes of foamy urine and high blood pressure, had physical and laboratorial exams indicating nephrotic syndrome. A renal biopsy was performed and focal and segmental glomerulosclerosis were observed under light microscopy in some glomeruli presented as tip lesion, and in others it was accompanied by podocyte hypertrophy and podocyte detachment in urinary space, compatible with podocytopathy FSGS. Besides, there were thickened capillary loops with basement membrane irregularities due to "spikes" compatible with MGN stage II. Immunofluorescence showed finely granular IgG, IgG4, and PLA2R deposits in capillary loops and, in electron microscopy, subepithelial deposits and foot process effacement. These morphological findings are compatible with FSGS and MGN stage II. CONCLUSIONS: In the present case, clinical and morphological characteristics showed a possible overlap of primary FSGS and MGN as focal and segmental glomerulosclerosis does not seem to be related with MGN progression but with the podocytopathy FSGS. Sociedade Brasileira de Nefrologia 2019-02-25 2020 /pmc/articles/PMC7213925/ /pubmed/30806447 http://dx.doi.org/10.1590/2175-8239-JBN-2018-0239 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
da Silva, Crislaine Aparecida
Custódio, Fabiano Bichuette
Monteiro, Maria Luíza Gonçalves dos Reis
Araújo, Stanley de Almeida
Araújo, Liliane Silvano
Côrrea, Rosana Rosa Miranda
dos Reis, Marlene Antônia
Machado, Juliana Reis
Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report
title Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report
title_full Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report
title_fullStr Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report
title_full_unstemmed Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report
title_short Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report
title_sort focal and segmental glomerulosclerosis and membranous nephropathy overlapping in a patient with nephrotic syndrome: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213925/
https://www.ncbi.nlm.nih.gov/pubmed/30806447
http://dx.doi.org/10.1590/2175-8239-JBN-2018-0239
work_keys_str_mv AT dasilvacrislaineaparecida focalandsegmentalglomerulosclerosisandmembranousnephropathyoverlappinginapatientwithnephroticsyndromeacasereport
AT custodiofabianobichuette focalandsegmentalglomerulosclerosisandmembranousnephropathyoverlappinginapatientwithnephroticsyndromeacasereport
AT monteiromarialuizagoncalvesdosreis focalandsegmentalglomerulosclerosisandmembranousnephropathyoverlappinginapatientwithnephroticsyndromeacasereport
AT araujostanleydealmeida focalandsegmentalglomerulosclerosisandmembranousnephropathyoverlappinginapatientwithnephroticsyndromeacasereport
AT araujolilianesilvano focalandsegmentalglomerulosclerosisandmembranousnephropathyoverlappinginapatientwithnephroticsyndromeacasereport
AT correarosanarosamiranda focalandsegmentalglomerulosclerosisandmembranousnephropathyoverlappinginapatientwithnephroticsyndromeacasereport
AT dosreismarleneantonia focalandsegmentalglomerulosclerosisandmembranousnephropathyoverlappinginapatientwithnephroticsyndromeacasereport
AT machadojulianareis focalandsegmentalglomerulosclerosisandmembranousnephropathyoverlappinginapatientwithnephroticsyndromeacasereport