Nodular glomerulosclerosis in a non-diabetic hypertensive, dyslipidemic, smoker
            patient: a case report

Araújo, Liliane Silvano; Queiroz, Alessandro Alves; Monteiro, Maria Luiza Reis; Silva, Crislaine Aparecida; Pereira, Lívia Helena de Morais; Cintra, Mariana Molinar Mauad; Borges, Cláudia Renata Bibiano; Machado, Juliana Reis; Reis, Marlene Antônia dos

doi:10.5935/0101-2800.20160076

Cited by 2 publications

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“…The finding of a TMA and a thrombomodulin mutation in this report may be a fortuitous discovery that sheds light on a possible connection between the alternative pathway of complement and ING. 1 – 10 , 15 – 27 The connections of ING to hyperlipidemia, obesity, and atherosclerosis are also interesting since they all represent inflammatory states, and this could be suggestive of a role for complement as well. 2 Studies of the coagulation cascade may be useful in ING and TMA presentations given that the coagulation cascade and the complement system interact.…”

Section: Discussionmentioning

confidence: 99%

Finding of pathological thrombomodulin gene variant in a patient with idiopathic nodular glomerulosclerosis and chronic thrombotic microangiopathy-like changes

Hanna

Zuckerman

Ferrey

et al. 2020

SAGE Open Medical Case Reports

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Idiopathic nodular glomerulosclerosis is an unusual histopathological finding that has commonly been observed in male smokers with hypertension. It has remained an enigmatic condition and is best described as a diabetic pattern of glomerular injury seen in non-diabetic patients. It is also one of the few nicotine (smoking)-associated/smoking-associated patterns of renal injury. We present an even more unusual manifestation of this pathological finding in a 59-year-old Hispanic female who presented with chronic kidney disease approaching need for renal replacement therapy. The patient had idiopathic nodular glomerulosclerosis on kidney biopsy, despite no prior history of diabetes, nor smoking history, including no secondhand smoking exposure. The patient did have hypertension. The renal biopsy also showed evidence of chronic thrombotic-microangiopathic changes within arteries and arterioles. Genetic testing of the alternative pathway revealed an unusual and likely pathological variant of thrombomodulin supporting complement dysfunction as having a role in the presentation.

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Section: Discussionmentioning

confidence: 99%

Finding of pathological thrombomodulin gene variant in a patient with idiopathic nodular glomerulosclerosis and chronic thrombotic microangiopathy-like changes

Hanna

Zuckerman

Ferrey

et al. 2020

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

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Idiopathic nodular glomerulosclerosis and differential diagnosis

et al. 2020

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Introduction: Idiopathic nodular glomerulosclerosis (ING) is a condition that has a vasculopathic glomerular histological pattern. Case presentation: The authors present the case of a 44-year-old Hispanic smoker female with hypertension and peripheral arterial disease who presented nephrotic syndrome for 2 weeks. The patient was diagnosed with ING by percutaneous renal biopsy results, which showed global nodular mesangial matrix expansion, with linear staining accentuation of glomerular and tubular basement membrane for Immunoglobulin G (IgG) and albumin on immunofluorescence. Conclusions: ING is a rare disease with a poor renal prognosis and wide diagnostic approach; we highlight the importance of analyzing every piece of detail together to reach a definitive diagnosis.

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Nodular glomerulosclerosis in a non-diabetic hypertensive, dyslipidemic, smoker patient: a case report

Cited by 2 publications

References 0 publications

Finding of pathological thrombomodulin gene variant in a patient with idiopathic nodular glomerulosclerosis and chronic thrombotic microangiopathy-like changes

Finding of pathological thrombomodulin gene variant in a patient with idiopathic nodular glomerulosclerosis and chronic thrombotic microangiopathy-like changes

Idiopathic nodular glomerulosclerosis and differential diagnosis

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