Lipoprotein Glomerulopathy With Complete Resolution With Fenofibrate: Report of First Case From Pakistan

Area of Science:

• Nephrology
• Pathology
• Epidemiology

Background:

• Lipoprotein glomerulopathy is a rare glomerular disorder causing nephrotic syndrome and kidney failure.
• Most reported cases originate from Japan and China, with limited documentation elsewhere.
• This study presents the first case of lipoprotein glomerulopathy identified in Pakistan.

Observation:

• A 25-year-old male with hypertension presented with edema, frothy urine, and fatigue.
• Renal biopsy revealed characteristic lipoprotein thrombi within glomerular capillaries.
• Electron microscopy confirmed lipid granules and vacuoles within the thrombi.

Findings:

• Treatment with fenofibrate, rosuvastatin, and captopril led to symptom resolution, normalized blood pressure, and improved lipid profiles.
• Follow-up biopsy demonstrated complete resolution of lipoprotein thrombi.
• Persistence of some subendothelial flocculent material was noted despite thrombi resolution.

Implications:

• This case highlights the importance of recognizing lipoprotein glomerulopathy in underreported regions like Pakistan.
• It contributes to understanding the histopathology and global distribution of this rare condition.
• The favorable response to fenofibrate suggests its efficacy in managing lipoprotein glomerulopathy.