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

Crislaine Aparecida da Silva1, Fabiano Bichuette Custódio1, Maria Luíza Gonçalves Dos Reis Monteiro1

  • 1Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.

Jornal Brasileiro De Nefrologia
|February 27, 2019
PubMed
Abstract

Insights

This case study presents a rare instance of primary membranous nephropathy (MGN) and primary focal segmental glomerulosclerosis (FSGS) co-occurring in a young patient. The findings suggest FSGS was independent of MGN progression.

Area of Science:

  • Nephrology
  • Pathology
  • Immunology

Background:

  • Membranous nephropathy (MGN) can present with focal segmental glomerulosclerosis (FSGS), often indicating disease progression.
  • Primary MGN and primary FSGS are distinct glomerular diseases.
  • Understanding their co-occurrence is crucial for accurate diagnosis and management.

Observation:

  • A 17-year-old female presented with nephrotic syndrome, including edema, foamy urine, and hypertension.
  • Renal biopsy revealed features of both MGN (Stage II) and FSGS (podocytopathy).
  • Immunofluorescence and electron microscopy confirmed subepithelial deposits and podocyte effacement.

Findings:

  • Morphological findings were consistent with a co-diagnosis of primary FSGS and primary MGN Stage II.
  • The observed FSGS was attributed to podocytopathy, not MGN progression.
  • This case highlights a potential overlap between these two distinct glomerular diseases.

Implications:

  • Challenges the traditional view of FSGS as solely a marker of MGN progression.
  • Suggests that primary FSGS and primary MGN can coexist independently.
  • Emphasizes the importance of detailed morphological and immunopathological analysis for diagnosing complex glomerular diseases.

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