Focal Glomerular Sclerosis

Know the Light Microscopy, Immunofluorescenc, and Electron Microscopy findings in Focal Glomerular Sclerosis

• Light Microscopy

• Segmental lesions may be missed if not enough glomeruli in biopsy

• Involvement of juxtamedullary glomeruli

• Sclerotic segments show collapse of BM, increase in matrix, and hyalinosis

• Lipoid droplets and foam cells often present

• Even ‘uninvolved’ glomeruli may show mesangial proliferation

• Immunofluorescence - IgM and C3 present in hyaline masses

• Electron Microscopy

• Effacement of foot processes

• Pronounced focal detachment of the epithelial cells with denudation of the underlying GBM

Know the clinical presentation of the majority of patients with Focal Glomerular Sclerosis

• FSG is associated with a higher frequency of hematuria and HTN than other idiopathic presentations of nephrotic syndrome

• Sterile pyuria is common

• Proteinuria is nonselective and occasionally may be asymptomatic

Know that there is a high rate of recurrence of the disease in the grafts, especially in well-matched grafts

Category: Pathology Notes