Summary of focal segmental glomerulosclerosis

Focal segmental glomerulosclerosis (focal segmental glomeralosclerosis) lesions as focal, segmental, involving only a small part of the glomerular Lesions of the glomerular capillary plexus showed segmental sclerosis is a common cause nephrotic syndrome, one of the reasons. More common in children and young people. This type of nephritis for patients on hormone treatment is not ideal. More than to continue to develop as diffuse sclerosing glomerulonephritis.
Pathological changes
Lesions as focal, often from the deep renal cortex near the medulla part of the small number of glomerular Only a small number of early glomerular involvement, other glomerular no obvious lesions or minor lesions. Lesions of the glomerular capillary plexus part of the capillary collapse, mesangial widening, sclerosis, hyalinization. Deposition of lipid droplets and the glass-like substance often mesorectal and capillaries. Sometimes seen engulfed lipid accumulation of foam cells. Electron microscope, the hardening part of the capillary basement membrane shrinkage, uneven thickness. The meantime visible electron-dense material and lipid droplets. Epithelial cell foot processes disappear. Immunofluorescence examination showed lesions of the glomeruli of immunoglobulin and complement deposition, mainly IgM and C3.
Glomerular capillary plexus, some sclerosis, hyalinization × 350
Lesions continue to develop the involvement of the glomerulus gradually increased. Some glomerular capillary plexus all fibrosis, sclerosis, hyalinization (global sclerosis). Corresponding tubular atrophy and fibrosis. Hyperplasia of the renal interstitial fibrosis, a small amount of lymphocytes and mononuclear cell infiltration, sometimes visible and the accumulation of foam cells. Late, a large number of glomerular sclerosis can lead to the development of diffuse sclerosing glomerulonephritis and renal insufficiency.
Clinical features and outcome
About 80% of patients with focal segmental glomerulosclerosis with nephrotic syndrome. Nephrotic syndrome in general, of which about 2/3, accompanied by hematuria, and often have high blood pressure. Massive proteinuria, and more non-selective. The patient bad effects of hormone therapy, only 20% to 30% efficiency. Lesions, often continue to develop, can lead to renal insufficiency. General outcomes for children than adults.
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