Epithelial Cell Foot Process Effacement in Podocytes in Focal and Segmental Glomerulosclerosis: A Quantitative Analysis

Abstract Introduction: Some cases of membranous nephropathy (MGN) present focal segmental glomerulosclerosis (FSGS) typically associated with disease progression. However, we report a case of a patient who seemed to have MGN and FSGS, both primary. Case presentation: A 17-year-old female, Caucasian, presenting lower extremity edema associated with episodes of foamy urine and high blood pressure, had physical and laboratorial exams indicating nephrotic syndrome. A renal biopsy was performed and focal and segmental glomerulosclerosis were observed under light microscopy in some glomeruli presented as tip lesion, and in others it was accompanied by podocyte hypertrophy and podocyte detachment in urinary space, compatible with podocytopathy FSGS. Besides, there were thickened capillary loops with basement membrane irregularities due to "spikes" compatible with MGN stage II. Immunofluorescence showed finely granular IgG, IgG4, and PLA2R deposits in capillary loops and, in electron microscopy, subepithelial deposits and foot process effacement. These morphological findings are compatible with FSGS and MGN stage II. Conclusions: In the present case, clinical and morphological characteristics showed a possible overlap of primary FSGS and MGN as focal and segmental glomerulosclerosis does not seem to be related with MGN progression but with the podocytopathy FSGS.

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Podocyte Foot Process Effacement in Postreperfusion Allograft Biopsies Correlates With Early Recurrence of Proteinuria in Focal Segmental Glomerulosclerosis

Transplantation Journal ◽

10.1097/tp.0b013e318250234a ◽

2012 ◽

Vol 93 (12) ◽

pp. 1238-1244 ◽

Cited By ~ 38

Author(s):

Jei-Wen Chang ◽

Victoriano Pardo ◽

Junichiro Sageshima ◽

Linda Chen ◽

Hsin-Lin Tsai ◽

...

Keyword(s):

Focal Segmental Glomerulosclerosis ◽

Early Recurrence ◽

Segmental Glomerulosclerosis ◽

Foot Process Effacement ◽

Foot Process

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Podocyte foot process effacement as a diagnostic tool in focal segmental glomerulosclerosis

Kidney International ◽

10.1038/ki.2008.413 ◽

2008 ◽

Vol 74 (12) ◽

pp. 1568-1576 ◽

Cited By ~ 89

Author(s):

Jeroen K.J. Deegens ◽

Henry B.P.M. Dijkman ◽

George F. Borm ◽

Eric J. Steenbergen ◽

José G. van den Berg ◽

...

Keyword(s):

Focal Segmental Glomerulosclerosis ◽

Diagnostic Tool ◽

Segmental Glomerulosclerosis ◽

Foot Process Effacement ◽

Foot Process

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Podocyte Foot Process Effacement in Postreperfusion Allograft Biopsies Correlates with Early Recurrence of Proteinuria in Focal Segmental Glomerulosclerosis

Transplantation Journal ◽

10.1097/tp.0b013e31829a12fe ◽

2013 ◽

Vol 96 (3) ◽

pp. e11-e12 ◽

Cited By ~ 4

Author(s):

Khaled Abdulnabi ◽

Abdul Hammad ◽

Ajay Sharma ◽

Sanjay Mehra ◽

Dan Ridgway

Keyword(s):

Focal Segmental Glomerulosclerosis ◽

Early Recurrence ◽

Segmental Glomerulosclerosis ◽

Foot Process Effacement ◽

Foot Process

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GLOMERULAR CAPILLARY GROWTH AND CELLULAR HYPERPLASIA IN A MODEL OF FOCAL AND SEGMENTAL GLOMERULOSCLEROSIS

Image Analysis & Stereology ◽

10.5566/ias.v19.p109-112 ◽

2011 ◽

Vol 19 (2) ◽

pp. 109

Author(s):

John F Bertram ◽

Meroe M Cahill

Keyword(s):

Glomerular Hypertrophy ◽

Focal And Segmental Glomerulosclerosis ◽

Cell Hyperplasia ◽

Renal Disorder ◽

Glomerular Cell ◽

Capillary Growth ◽

Glomerular Capillary ◽

Segmental Glomerulosclerosis ◽

Glomerular Lesions ◽

Foot Process

Focal and segmental glomerulosclerosis (FSGS) is a chronic renal disorder characterized by segmental glomerular lesions and widespread podocyte foot process effacement. We have previously shown that glomerular enlargement (hypertrophy) precedes the development of FSGS in an animal model not previously thought to involve glomerular hypertrophy. This hypertrophy involved growth of glomerular capillaries. The aim of the present study was to determine whether the capillary growth involved an increase in the number of capillaries per glomerulus, or lengthening of existing capillaries. In addition, we examined the contribution of glomerular cell hyperplasia to the hypertrophy. We found that glomerular capillary growth in this model appears to primarily involve lengthening of existing capillaries rather that sprouting of new capillaries, and that glomerular cell proliferation contributes to the glomerular hypertrophy.

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Degree of foot process effacement in patients with genetic focal segmental glomerulosclerosis: a single-center analysis and review of the literature

Scientific Reports ◽

10.1038/s41598-021-91520-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kiyonobu Ishizuka ◽

Kenichiro Miura ◽

Taeko Hashimoto ◽

Naoto Kaneko ◽

Yutaka Harita ◽

...

Keyword(s):

Focal Segmental Glomerulosclerosis ◽

Cytoskeletal Proteins ◽

Systematic Evaluation ◽

Review Of The Literature ◽

Segmental Glomerulosclerosis ◽

Native Kidney ◽

Foot Process Effacement ◽

Genes Encoding ◽

Foot Process ◽

Almost All

AbstractDetermining the cause of focal segmental glomerulosclerosis (FSGS) has crucial implications for evaluating the risk of posttransplant recurrence. The degree of foot process effacement (FPE) on electron micrographs (EM) of native kidney biopsies can reportedly differentiate primary FSGS from secondary FSGS. However, no systematic evaluation of FPE in genetic FSGS has been performed. In this study, percentage of FPE and foot process width (FPW) in native kidney biopsies were analyzed in eight genetic FSGS patients and nine primary FSGS patients. All genetic FSGS patients showed segmental FPE up to 38% and FPW below 2000 nm, while all primary FSGS patients showed diffuse FPE above 88% and FPW above 3000 nm. We reviewed the literature which described the degree of FPE in genetic FSGS patients and identified 38 patients with a description of the degree of FPE. The degree of FPE in patients with mutations in the genes encoding proteins associated with slit diaphragm and cytoskeletal proteins was varied, while almost all patients with mutations in other FSGS genes showed segmental FPE. In conclusion, the present study suggests that the degree of FPE in native kidney biopsies may be useful for differentiating some genetic FSGS patients from primary FSGS patients.

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