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

Detalhes bibliográficos
Autor(a) principal: Silva,Crislaine Aparecida da
Data de Publicação: 2020
Outros Autores: Custódio,Fabiano Bichuette, Monteiro,Maria Luíza Gonçalves dos Reis, Araújo,Stanley de Almeida, Araújo,Liliane Silvano, Côrrea,Rosana Rosa Miranda, Reis,Marlene Antônia dos, Machado,Juliana Reis
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Nefrologia
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000100113
Resumo: Abstract 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.
id SBN-1_b8ddec493351a353015c2fb7c0218e3d
oai_identifier_str oai:scielo:S0101-28002020000100113
network_acronym_str SBN-1
network_name_str Jornal Brasileiro de Nefrologia
repository_id_str
spelling Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case reportGlomerulosclerosis, Focal SegmentalGlomerulonephritis, MembranousNephrotic SyndromeAbstract 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 Nefrologia2020-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000100113Brazilian Journal of Nephrology v.42 n.1 2020reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-2018-0239info:eu-repo/semantics/openAccessSilva,Crislaine Aparecida daCustódio,Fabiano BichuetteMonteiro,Maria Luíza Gonçalves dos ReisAraújo,Stanley de AlmeidaAraújo,Liliane SilvanoCôrrea,Rosana Rosa MirandaReis,Marlene Antônia dosMachado,Juliana Reiseng2020-04-17T00:00:00Zoai:scielo:S0101-28002020000100113Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2020-04-17T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false
dc.title.none.fl_str_mv 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
spellingShingle Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report
Silva,Crislaine Aparecida da
Glomerulosclerosis, Focal Segmental
Glomerulonephritis, Membranous
Nephrotic Syndrome
title_short 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_sort Focal and Segmental Glomerulosclerosis and Membranous Nephropathy overlapping in a patient with Nephrotic Syndrome: a case report
author Silva,Crislaine Aparecida da
author_facet Silva,Crislaine Aparecida da
Custódio,Fabiano Bichuette
Monteiro,Maria Luíza Gonçalves dos Reis
Araújo,Stanley de Almeida
Araújo,Liliane Silvano
Côrrea,Rosana Rosa Miranda
Reis,Marlene Antônia dos
Machado,Juliana Reis
author_role author
author2 Custódio,Fabiano Bichuette
Monteiro,Maria Luíza Gonçalves dos Reis
Araújo,Stanley de Almeida
Araújo,Liliane Silvano
Côrrea,Rosana Rosa Miranda
Reis,Marlene Antônia dos
Machado,Juliana Reis
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Silva,Crislaine Aparecida da
Custódio,Fabiano Bichuette
Monteiro,Maria Luíza Gonçalves dos Reis
Araújo,Stanley de Almeida
Araújo,Liliane Silvano
Côrrea,Rosana Rosa Miranda
Reis,Marlene Antônia dos
Machado,Juliana Reis
dc.subject.por.fl_str_mv Glomerulosclerosis, Focal Segmental
Glomerulonephritis, Membranous
Nephrotic Syndrome
topic Glomerulosclerosis, Focal Segmental
Glomerulonephritis, Membranous
Nephrotic Syndrome
description Abstract 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.
publishDate 2020
dc.date.none.fl_str_mv 2020-03-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000100113
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002020000100113
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/2175-8239-jbn-2018-0239
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
dc.source.none.fl_str_mv Brazilian Journal of Nephrology v.42 n.1 2020
reponame:Jornal Brasileiro de Nefrologia
instname:Sociedade Brasileira de Nefrologia (SBN)
instacron:SBN
instname_str Sociedade Brasileira de Nefrologia (SBN)
instacron_str SBN
institution SBN
reponame_str Jornal Brasileiro de Nefrologia
collection Jornal Brasileiro de Nefrologia
repository.name.fl_str_mv Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)
repository.mail.fl_str_mv ||jbn@sbn.org.br
_version_ 1752122065731715072