title: Idiopathic nodular glomerulosclerosis in a never-smoking, normotensive, non-obese, normal-glucose-tolerant middle-aged woman.
abstract: A 53-year-old woman with a history of dyslipidemia presented with medium-grade proteinuria and several years of progressive renal dysfunction. Renal biopsy showed diffuse and global Kimmelstiel-Wilson nodule like nodular mesangial sclerosis, but she had no history of diabetes mellitus, no diabetic retinopathy and normal oral glucose tolerance. Congo red staining was negative, and immunofluorescence staining showed no immunoglobulin deposition including kappa or lambda light chains. Electron microscopy showed no electron dense deposits or organized deposits. Thus, we diagnosed idiopathic nodular glomerulosclerosis (ING). ING is a recently established clinicopathologic disease entity linked to longstanding cigarette smoking and hypertension. Obesity is also listed as a contributing factor. However, none of these factors was documented in this case. This is a valuable case of ING that suggests the existence of as-yet unknown causative factors of ING other than smoking, hypertention or obesity.
authors.affiliation: Department of Nephrology , National Defense Medical College , Tokorozawa, Saitama , Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uchida
authors.affiliation: Department of Nephrology , National Defense Medical College , Tokorozawa, Saitama , Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Oda
authors.affiliation: Department of Nephrology , National Defense Medical College , Tokorozawa, Saitama , Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Department of Nephrology , National Defense Medical College , Tokorozawa, Saitama , Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Higashi
authors.affiliation: Department of Laboratory Medicine , National Defense Medical College , Tokorozawa, Saitama , Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Katsurada
authors.affiliation: Department of Laboratory Medicine , National Defense Medical College , Tokorozawa, Saitama , Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimazaki
authors.affiliation: Department of Laboratory Medicine , National Defense Medical College , Tokorozawa, Saitama , Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Tamai
authors.affiliation: Department of Nephrology , National Defense Medical College , Tokorozawa, Saitama , Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Kumagai
keywords: CD34; diabetic nephropathy; idiopathic nodular glomerulosclerosis; vascular endothelial growth factor