title: A case of idiopathic nodular glomerulosclerosis with fibrin caps.
abstract: We report a case of idiopathic nodular glomerulosclerosis (ING) mimicking diabetic Kimmelstiel-Wilson glomerulopathy. A 72-year-old man suffering from nephritic syndrome and renal dysfunction had no prior history of diabetes mellitus, but had impaired glucose tolerance and a history of hypertension and smoking. A kidney biopsy showed increased mesangial matrix with Kimmelstiel-Wilson-like nodules, glomerular basement membrane thickening and capillary microaneurysms. Additionally, a large amount of fibrin caps detectable as electron-dense subendothelial material by electron microscopy were observed. Although ING with fibrin caps has been rarely reported, the large number of fibrin caps seen in this case may be due to the advanced clinical stage.
authors.affiliation: Division of Nephrology, Kyoto Min-Iren Chuo Hospital, 16-1 Kasuga-cho, Nishinokyo, Nakagyo-ku, Kyoto 604-8453, Japan. kino-chi@fc4.so-net.ne.jp
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kinoshita
authors.forename: Yoshimoto
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kanda
authors.forename: Chiaki
authors.initials: C
authors.lastname: Kanda
mesh_terms: D000368:Aged; D001706:Biopsy; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D005337:Fibrin / Q000032:analysis*; D005920:Glomerular Mesangium / Q000737:chemistry* / Q000648:ultrastructure; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D011237:Predictive Value of Tests
chemical_list: D005337:Fibrin