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Podocyte Infolding Glomerulopathy Masquerading as Membranous Nephropathy - A Shared Pathogenesis?
Smita Mary Matthai1,2, Liam Hems2, Yee Wah Tsang2
1Central EM Facility, Christian Medical College, Vellore, Tamil Nadu, India.
Abstract:
Podocyte infolding glomerulopathy (PIG) is a rare pathological entity, diagnosed by electron microscopic demonstration of diffuse infolding of the podocytes into the glomerular basement membranes. We report the first case from United Kingdom exhibiting typical ultrastructural features of PIG in a male with Type II diabetes mellitus, hypertension and common variable immune deficiency. Renal biopsy revealed phospholipase A2 receptor (PLA2R) immunostain positive membranous nephropathy (MN) but no serum PLA2R antibodies. Diffuse infolding of the podocytes into the glomerular basement membranes along with pathognomonic microspherular and microtubular intra basement membrane clusters distributed diffusely and globally were noted on electron microscopy, diagnostic of PIG. We postulate a shared pathomechanistic link between PIG and MN, highlighting the overlapping features of both conditions.
Insights
Podocyte infolding glomerulopathy (PIG), a rare kidney disease, was identified in a UK patient with diabetes and immune deficiency. Electron microscopy confirmed PIG, suggesting a link with membranous nephropathy.
Area of Science:
- Nephrology
- Pathology
- Electron Microscopy
Background:
- Podocyte infolding glomerulopathy (PIG) is a rare kidney disease characterized by podocyte infolding into glomerular basement membranes.
- This case represents the first reported instance of PIG in the United Kingdom.
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