[Focal segmental glomerular hyalinosis: a special form of fibroplastic glomerulonephritis]

Focal segmentary glomerular hyalinosis (FSGH) presenting a picture of glomerulonephritis of the nephrotic type is characterized morphologically. Clinico-morphological criteria for diagnosis are presented. FSGH is characterized by a severe nephrotic syndrome, progressive course, and refractoriness to immunosuppressive therapy, focal and segmentary pattern of changes in the glomeruli, the presence of hyalin masses in some lobules of glomerular capillaries, lipid inclusions in mesangial and endothelial cells, tubular epithelial cells and interstitium, as well as uneven outlines of the endothelial surface of the basal membrane of glomerular capillaries. The diagnosis of early changes in FSGH was shown to require light and electron microscopic and immunohistochemical examinations of kidney biopsies. The problems of the etiology and pathogenesis of FSGH and its independence as a nosological entity are discussed.