title: A case of IgA nephritis showing diffuse podocytic detachment from the glomerular basement membrane.
abstract: We report the case of a 15-year-old Japanese female with severe mesangial proliferative IgA glomerulonephritis who showed a dramatic response to cocktail therapy for nephrotic syndrome. She had suddenly developed massive proteinuria and microscopic hematuria. The first renal biopsy at one month after onset revealed severe mesangial hypercellularity and podocytic detachment from the glomerular basement membrane (GBM). The cocktail therapy resulted in a decrease of proteinuria clinically, and a second biopsy demonstrated repair of the podocytic detachment. We suggest that the massive proteinuria in this case was due to destruction of the size barrier by detachment of podocytes from the GBM, and the repair of the podocytic covering on the GBM was accelerated by the cocktail therapy.
authors.affiliation: Department of Pathology, Shinshu University School of Medicine, Nagano, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Moriya
authors.forename: K
authors.initials: K
authors.lastname: Nakazawa
authors.forename: N
authors.initials: N
authors.lastname: Itoh
authors.forename: H
authors.initials: H
authors.lastname: Shigematsu
authors.forename: M
authors.initials: M
authors.lastname: Higuchi
authors.forename: M
authors.initials: M
authors.lastname: Miyasaka
authors.forename: H
authors.initials: H
authors.lastname: Oguchi
mesh_terms: D000293:Adolescent; D001485:Basement Membrane / Q000648:ultrastructure; D003520:Cyclophosphamide / Q000627:therapeutic use; D004176:Dipyridamole / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D005922:Glomerulonephritis, IGA / Q000188:drug therapy / Q000473:pathology*; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007678:Kidney Glomerulus / Q000648:ultrastructure*; D011239:Prednisolone / Q000627:therapeutic use; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D014859:Warfarin; D004176:Dipyridamole; D005665:Furosemide; D003520:Cyclophosphamide; D011239:Prednisolone