Idiopathic adult focal segmental glomerulosclerosis: a clinicopathological study and response to steroid.
A total of 65 adult cases (53 males, 12 females) with biopsy-proven focal segmental glomerulosclerosis (FSGS) were studied. Hypertension, ascites and haematuria were seen in 13, 12 and 24 cases, respectively. Decreased creatinine clearance at presentation was found in 9 cases. Mean proteinuria per day, serum cholesterol and total protein were 7.5 +/- 4.3 g, 388.95 +/- 213.4 mg% (10.11 +/- 5.55 mmol/l) and 5.27 +/- 1.1 g% (0.527 +/- 0.11 milligram), respectively. Mesangial proliferation was seen in 13 cases and hilar sclerosis in 5. Fifty percent showed positive immunofluorescence; IgM in 10, C3 in 8, and IgG in 2. Forty-two cases could be followed (mean 32 months), out of which 38 had nephrotic syndrome and were treated with prednisolone; 58% showed response (31% complete remission and 27% partial remission). One patient in each group of responders and nonresponders had renal failure at the end of follow-up. Hypertension, degree of proteinuria, mesangial proliferation, degree of tubular atrophy and immunofluorescence findings did not significantly affect the response to steroids. We conclude that a group of patients with idiopathic adult FSGS has a favourable response to steroids, which cannot be predicted clinically.
Agarwal
S K
SK
Department of Nephrology and Pathology, All India Institute of Medical Sciences, New Delhi.
Dash
S C
SC
Tiwari
S C
SC
Bhuyan
U N
UN
D000293:Adolescent; D000328:Adult; D001284:Atrophy; D001706:Biopsy; D003404:Creatinine / Q000652:urine; D005260:Female; D005455:Fluorescent Antibody Technique; D005500:Follow-Up Studies; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D006417:Hematuria / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000503:physiopathology; D007684:Kidney Tubules / Q000473:pathology / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D011507:Proteinuria / Q000473:pathology / Q000503:physiopathology
D011239:Prednisolone; D003404:Creatinine