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[Clinical and pathological analyses of lipoprotein glomerulopathy]
Zhang-xue Hu1, Xiu-hui Zhang, Zhao-hui Sha
1Department of Internal Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Insights
Lipoprotein glomerulopathy is a kidney disease characterized by glomerular capillary casts positive for apoE. Clinical signs include edema, proteinuria, low albumin, and anemia.
Area of Science:
- Nephrology
- Pathology
- Biochemistry
Context:
- Lipoprotein glomerulopathy (LPG) is a rare kidney disease.
- Understanding its clinical and pathological features is crucial for diagnosis and management.
Purpose:
- This study aimed to investigate the clinical and pathological characteristics of lipoprotein glomerulopathy.
Summary:
- Retrospective analysis of 3 LPG cases (1 male, 2 female, young Han ethnicity).
- Clinical presentation included edema, proteinuria (0.8-1.5 g/d), hypoalbuminemia, anemia, elevated creatinine, hypertension, and hyperlipidemia.
- Pathological findings revealed enlarged glomeruli with prominent, pale, mesh-like casts in capillary lumens, positive for apolipoprotein E (apoE) and faint immunoglobulin deposits.
Impact:
- Highlights the diagnostic significance of apoE-positive glomerular casts.
- Correlates specific clinical manifestations with pathological findings in LPG.
- Contributes to the understanding of LPG's pathophysiology and clinical spectrum.
Objective:
To investigate the clinical and pathological characteristics of lipoprotein glomerulopathy.
Methods:
We retrospectively analyzed 3 cases of lipoprotein glomerulopathy.
Results:
The 3 patients, 1 male and 2 females, were young Hans. They were admitted to our hospital because of edema. Patient 1 had a positive family history. Her proteinuria ranged between 0.8-1.5 g/d, her serum albumin levels were below the normal lower limit, and she was afflicted with anemia. Patient 2 was found having slightly increased serum creatinine, hypertension, and increased total cholesterol and triglyceride level. The kidneys of patient 3 were enlarged. Increments of glomerular size and capillary lumen space were observed under microscope. Bioptic specimens of the patients' kidneys displayed extensive prominent lucent casts in the capillary lumen, which were stained as pale mesh-like substance and were not stained by silver impregnation. Immunofluorescence microscopy revealed faint immunoglobulin deposit. These casts were stained positive for apoE.
Conclusion:
Lipoprotein glomerulopathy is pathologically characterized by extensive glomerular capillary casts which are stained positive for apoE, and clinically it is characterized by edema, proteinuria, hypoalbuminaemia and anemia.
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