Korbet S M, Schwartz M M, Lewis E J
Department of Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
Am J Kidney Dis. 1988 Mar;11(3):270-6. doi: 10.1016/s0272-6386(88)80162-8.
We describe the clinicopathologic course of two patients with recurrent focal segmental glomerular sclerosis (FSGS). In both patients, FSGS was initially demonstrated during the evaluation of proteinuria. After progressing to end-stage renal disease, each patient received a living-related renal transplant. Shortly after transplantation, proteinuria recurred in both patients, progressing to the nephrotic syndrome. Serial renal biopsies were obtained from each patient. These initially demonstrated focal segmental epithelial proliferation (the "cellular lesion"), but focal segmental scars were observed in subsequent biopsies. None of the biopsies demonstrated immunoglobulin, complement deposition, or diffuse epithelial cell foot process fusion. These findings suggest that the scarring lesion in recurrent FSGS may be the result of a primary process involving damage to a limited number of visceral epithelial cells.
我们描述了两名复发性局灶节段性肾小球硬化（FSGS）患者的临床病理过程。在这两名患者中，FSGS最初都是在蛋白尿评估过程中被发现的。进展至终末期肾病后，每名患者均接受了亲属活体肾移植。移植后不久，两名患者均再次出现蛋白尿，并进展为肾病综合征。对每名患者进行了系列肾活检。这些活检最初显示局灶节段性上皮细胞增殖（“细胞性病变”），但在随后的活检中观察到局灶节段性瘢痕形成。所有活检均未显示免疫球蛋白、补体沉积或弥漫性上皮细胞足突融合。这些发现提示，复发性FSGS中的瘢痕形成病变可能是一个主要过程的结果，该过程涉及有限数量的脏层上皮细胞受损。
