title: Intramembranous microspherical structures in focal segmental glomerulosclerosis.
abstract: A 45-year-old male had proteinuria for 3 years. For persistent proteinuria over 2 g/day, he underwent renal biopsy. Light microscopy revealed focal segmental glomerulosclerosis together with diffuse capillary wall thickening. Periodic acid methenamine silver (PAM) staining showed a prominent bubbly appearance without spike formation could be found in almost all capillary walls. Electron microscopy revealed many microspheres measuring 50-70 nm in diameter distributed in diffuse and global fashion together with the thickened glomerular basement membrane. A few cytoplasmic processes of the podocytes showed infolding to the GBM. The patient exhibited no symptoms and no physical and serological findings suggesting autoimmune disease, such as systemic lupus erythematosus or Sjögren's syndrome. Therefore, the present case is important, because the peculiar microstructure in the GBM was noted in focal segmental glomerulosclerosis, which has never been reported in the literature.
authors.affiliation: Kyoto Min-iren Chuo Hospital, Kyoto, Japan. gagen923@hotmail.co.jp
authors.forename: Yoshimoto
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kanda
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kinoshita
authors.forename: Chiaki
authors.initials: C
authors.lastname: Kanda
authors.forename: Kensuke
authors.initials: K
authors.lastname: Joh
mesh_terms: D050533:Glomerular Basement Membrane / Q000473:pathology / Q000648:ultrastructure*; D005923:Glomerulosclerosis, Focal Segmental / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008854:Microscopy, Electron; D008863:Microspheres; D008875:Middle Aged; D050199:Podocytes / Q000473:pathology / Q000648:ultrastructure*
chemical_list: D007074:Immunoglobulin G