Biomaterial Database

Focal segmental glomerular sclerosis: the cellular lesion. 1985

M M Schwartz, and E J Lewis

The pathological features of 59 renal biopsy specimens with focal segmental glomerular sclerosis (FSG) were correlated with the patient's clinical and laboratory findings at the time of biopsy. Two morphologic patterns were identified: thirty-nine biopsy specimens had only focal segmental scars which were frequently associated with hyaline deposits. In 20 scars which were frequently associated with hyaline deposits. In 20 biopsy specimens with FSG, the glomeruli also contained a cellular lesion. It consisted of hypercellularity in the involved portion of the glomerulus, increased cells in the surrounding Bowman's space, and reactive and proliferative changes in the associated glomerular visceral epithelial cells. The cellular lesion was seen overlying glomerular capillaries with minimal histologic abnormalities and adjacent to scars. However, it was usually superimposed upon a segmental scar or a portion of the glomerulus with collapsed capillaries and wrinkled, folded basement membranes. Immunofluorescence and electron microscopy did not demonstrate significant immune reactants or electron-dense deposits in the glomeruli. Nineteen of 39 patients with only segmental scars had proteinuria equal to or greater than 3.0 g/day, and nine had the nephrotic syndrome. Eighteen of 20 patients with the cellular lesion had proteinuria equal to or greater than 3.0 g/day, and 14 had the nephrotic syndrome. The interval between the onset of proteinuria and biopsy was much shorter in patients with the cellular lesion (3.4 +/- 3 vs. 71.9 +/- 87 months, mean +/- SD, P less than 0.01). This difference was also significant when only those with nephrotic range proteinuria were compared (3.4 +/- 3 vs. 45.6 +/- 73 months, mean +/- SD, P less than 0.01). Patients with FSG, with or without the cellular lesion, were similar with respect to male/female ratio, age, serum creatinine, and diastolic blood pressure. From these observations, we believe that glomerular injury, evidenced by segmental proliferative lesions with signs of epithelial cell injury, is a significant factor in the pathogenesis of FSG.(ABSTRACT TRUNCATED AT 250 WORDS)

UI	MeSH Term	Description	Entries
D007075	Immunoglobulin M	A class of immunoglobulin bearing mu chains (IMMUNOGLOBULIN MU-CHAINS). IgM can fix COMPLEMENT. The name comes from its high molecular weight and originally was called a macroglobulin.	Gamma Globulin, 19S,IgM,IgM Antibody,IgM1,IgM2,19S Gamma Globulin,Antibody, IgM
D007678	Kidney Glomerulus	A cluster of convoluted capillaries beginning at each nephric tubule in the kidney and held together by connective tissue.	Glomerulus, Kidney
D008297	Male		Males
D008854	Microscopy, Electron	Microscopy using an electron beam, instead of light, to visualize the sample, thereby allowing much greater magnification. The interactions of ELECTRONS with specimens are used to provide information about the fine structure of that specimen. In TRANSMISSION ELECTRON MICROSCOPY the reactions of the electrons that are transmitted through the specimen are imaged. In SCANNING ELECTRON MICROSCOPY an electron beam falls at a non-normal angle on the specimen and the image is derived from the reactions occurring above the plane of the specimen.	Electron Microscopy
D008856	Microscopy, Fluorescence	Microscopy of specimens stained with fluorescent dye (usually fluorescein isothiocyanate) or of naturally fluorescent materials, which emit light when exposed to ultraviolet or blue light. Immunofluorescence microscopy utilizes antibodies that are labeled with fluorescent dye.	Fluorescence Microscopy,Immunofluorescence Microscopy,Microscopy, Immunofluorescence,Fluorescence Microscopies,Immunofluorescence Microscopies,Microscopies, Fluorescence,Microscopies, Immunofluorescence
D009404	Nephrotic Syndrome	A condition characterized by severe PROTEINURIA, greater than 3.5 g/day in an average adult. The substantial loss of protein in the urine results in complications such as HYPOPROTEINEMIA; generalized EDEMA; HYPERTENSION; and HYPERLIPIDEMIAS. Diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction.	Childhood Idiopathic Nephrotic Syndrome,Frequently Relapsing Nephrotic Syndrome,Multi-Drug Resistant Nephrotic Syndrome,Pediatric Idiopathic Nephrotic Syndrome,Steroid-Dependent Nephrotic Syndrome,Steroid-Resistant Nephrotic Syndrome,Steroid-Sensitive Nephrotic Syndrome,Multi Drug Resistant Nephrotic Syndrome,Nephrotic Syndrome, Steroid-Dependent,Nephrotic Syndrome, Steroid-Resistant,Nephrotic Syndrome, Steroid-Sensitive,Nephrotic Syndromes,Steroid Dependent Nephrotic Syndrome,Steroid Resistant Nephrotic Syndrome,Steroid Sensitive Nephrotic Syndrome,Steroid-Dependent Nephrotic Syndromes,Steroid-Resistant Nephrotic Syndromes,Steroid-Sensitive Nephrotic Syndromes,Syndrome, Nephrotic,Syndrome, Steroid-Sensitive Nephrotic
D011507	Proteinuria	The presence of proteins in the urine, an indicator of KIDNEY DISEASES.	Proteinurias
D004804	Eosinophils	Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin.	Eosinophil
D005260	Female		Females
D005921	Glomerulonephritis	Inflammation of the renal glomeruli (KIDNEY GLOMERULUS) that can be classified by the type of glomerular injuries including antibody deposition, complement activation, cellular proliferation, and glomerulosclerosis. These structural and functional abnormalities usually lead to HEMATURIA; PROTEINURIA; HYPERTENSION; and RENAL INSUFFICIENCY.	Bright Disease,Kidney Scarring,Glomerulonephritides,Scarring, Kidney