IgM-associated mesangial proliferative glomerulonephritis and focal and segmental hyalinosis with nephrotic syndrome

We present the case of an adult patient with the nephrotic syndrome. Morphologic and immunofluorescence studies revealed IgM-associated mesangial proliferative glomerulonephritis. On repeat biopsy, progression to focal glomerulosclerosis was noticed. The pathophysiological aspects of this evolution are discussed.