Lipoprotein Glomerulopathy in a Hispanic Female: A Case Report and Literature Review
Nasma K Majeed1, Jeanette McLaughlin2, Miguel Gonzalez3
1Department of Pathology, The University of Illinois at Chicago, USA.
Insights
Lipoprotein glomerulopathy (LPG), a rare kidney disease, is reported for the first time in a Hispanic female. Initial treatment with fenofibrate showed temporary improvement, but progressive renal failure necessitated transplant referral.
Area of Science:
- Nephrology
- Rare Diseases
- Genetics and Genomics
Background:
- Lipoprotein glomerulopathy (LPG) is a rare renal disorder characterized by lipoprotein thrombi in glomerular capillaries, leading to proteinuria and kidney failure.
- While predominantly reported in Asian populations, LPG has been documented in other ethnicities.
Purpose of the Study:
- To report the first known case of Lipoprotein glomerulopathy (LPG) in a Hispanic female.
- To describe the clinical presentation, diagnosis, and management of LPG in this unique patient.
Main Methods:
- A 28-year-old Hispanic female with hypertension and hyperlipidemia presented with symptoms of renal disease.
- Kidney biopsy revealed glomerular capillary lipoprotein thrombi, confirmed by Oil-Red-O staining.
- Treatment involved fenofibrate for hyperlipidemia and renal function support.
Main Results:
- The patient initially showed improvement in lipid profile and renal function after fenofibrate treatment.
- However, renal function declined after one year, leading to referral for kidney transplantation.
- This case represents the first documented instance of LPG in a Hispanic female.
Conclusions:
- Lipoprotein glomerulopathy (LPG) can affect individuals of diverse ethnic backgrounds.
- Early diagnosis and management are crucial, though long-term outcomes may still involve progressive renal failure.
- This case highlights the importance of considering LPG in patients with unexplained proteinuria and renal dysfunction, irrespective of ethnicity.
Rationale:
Lipoprotein glomerulopathy (LPG) is a rare renal disorder that features glomerular capillary lipoprotein thrombi, proteinuria, and progressive renal failure. Although most reported cases describe involvement in Asian patients, occurrence in Caucasian and other ethnicities has also been reported.
Presenting Concern:
A 28-year-old Hispanic female with a past medical history of hypertension, high cholesterol, gastritis, and a strong family history of renal disease presented with abdominal pain. On admission, her blood pressure was elevated. A computed tomography scan was unremarkable. Her laboratory studies showed proteinuria, high creatinine level, and an abnormal lipid profile.
Diagnosis:
The kidney biopsy showed glomerular capillary lipoprotein thrombi that stained positively for Oil-Red-O, confirming the lipid nature of the material consistent with LPG.
Intervention:
After stabilizing her blood pressure, the patient was started on fenofibrate to treat her high cholesterol and improve her renal function.
Outcome:
Her lipid profile and renal function were initially improved. However, after one year of treatment, her renal function started to decline and the patient was referred to a transplant center for further management.
Novel Finding:
To the best of our knowledge, this the first reported incidence of LPG in a Hispanic female.
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