Vakhshoori Mehrbod, Hanna Paul E, Obaidi Zainab, Chen Wongworawat Yan, Abdipour Amir, Norouzi Sayna
Loma Linda University Medical Center, CA, USA.
Medical College of Wisconsin, Milwaukee, USA.
J Investig Med High Impact Case Rep. 2025 Jan-Dec;13:23247096251323066. doi: 10.1177/23247096251323066. Epub 2025 Mar 11.
Idiopathic nodular glomerulosclerosis (ING) is mostly associated with long-standing active smoking and hypertension (HTN). Herein, we present a rare case of ING in a passive smoker with recently diagnosed uncontrolled HTN. A 60-year-old white female with Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder, Skin changes (POEMS) syndrome and newly diagnosed HTN was referred because of an elevated creatinine level. She denied being an active smoker but reported long-term exposure to cigarette smoke due to living with a heavy smoking family and working as a bartender. Further investigations revealed microscopic hematuria and nephritic range proteinuria. Kidney biopsy revealed diffuse and focal nodular mesangial expansion without hypercellularity, with negative staining for amyloid, fibrillary glomerulonephritis, and immunoglobulins, leading to a diagnosis of ING. This case highlights a rare case of ING secondary to heavy passive smoking and uncontrolled HTN.
特发性结节性肾小球硬化（ING）大多与长期大量主动吸烟和高血压（HTN）相关。在此，我们报告一例罕见的ING病例，患者为被动吸烟者，近期诊断为未控制的高血压。一名60岁白人女性，患有多神经病、器官肿大、内分泌病、单克隆浆细胞病、皮肤改变（POEMS）综合征且新诊断为高血压，因肌酐水平升高前来就诊。她否认主动吸烟，但报告称由于与重度吸烟的家人一起生活以及从事酒吧招待工作，长期接触香烟烟雾。进一步检查发现镜下血尿和肾病范围蛋白尿。肾活检显示弥漫性和局灶性结节性系膜扩张，无细胞增多，淀粉样蛋白、纤维性肾小球肾炎和免疫球蛋白染色均为阴性，诊断为ING。该病例突出了一例由重度被动吸烟和未控制的高血压继发的罕见ING病例。
