title: Macrophage Infiltration into the Glomeruli in Lipoprotein Glomerulopathy.
abstract: Lipoprotein glomerulopathy (LPG) is characterized by histopathological features showing intra-glomerular lipoprotein thrombi and type III hyperlipoproteinemia (HLP), with heterozygote mutation of apolipoprotein (apo) E gene. On the other hand, as another renal lipidosis with type III HLP, apoE2 homozygote-related glomerulopathy (apoE2-GN) showing foamy macrophages has been reported. The case of a 25-year-old man who had LPG by clinical behavior and gene analysis, but demonstrated atypical histopathological features with a substantial amount of foamy macrophage infiltration in the glomeruli, is presented. The combination of alleles for apoE Tokyo/Maebashi and classical apoE2 (Arg158Cys) was inferred to be the leading cause of the unique renal pathology with lipoprotein thrombi and foamy macrophages. In addition, foamy macrophages infiltrated some part of the apoE-positive region within the glomerulus, but did not exist in lipoprotein thrombi despite apoE positivity, suggesting that properties of apoE are crucial in the development of LPG rather than macrophage function. This case provides important information related to the pathogenesis of LPG and apoE2-GN.
authors.affiliation: Department of Internal Medicine, Saiseikai Yamagata Saisei Hospital, Yamagata, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takasaki
authors.affiliation: Department of Nursing, Faculty of Health Science, Yamagata Prefectural University of Health Sciences, Yamagata, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Joh
authors.affiliation: Department of Internal Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Yamakage
authors.affiliation: Department of Internal Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Fukase
authors.affiliation: Department of Internal Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Internal Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Laboratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Matsunaga
authors.affiliation: Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Saito
keywords: Form cell; Lipoprotein glomerulopathy; Macrophage; apoE Tokyo/Maebashi; apoE2