A case of idiopathic nodular glomerulosclerosis with fibrin caps

Abstract

We report a case of idiopathic nodular glomerulosclerosis (ING) mimicking diabetic Kimmelstiel-Wilson glomerulopathy. A 72-year-old man suffering from nephritic syndrome and renal dysfunction had no prior history of diabetes mellitus, but had impaired glucose tolerance and a history of hypertension and smoking. A kidney biopsy showed increased mesangial matrix with Kimmelstiel-Wilson-like nodules, glomerular basement membrane thickening and capillary microaneurysms. Additionally, a large amount of fibrin caps detectable as electron-dense subendothelial material by electron microscopy were observed. Although ING with fibrin caps has been rarely reported, the large number of fibrin caps seen in this case may be due to the advanced clinical stage.

Diabetic Nephropathy without Diabetes

“…In order to have homogeneity as to the diagnostic criteria and recorded data, records published before 1999 were excluded ( n = 14). Twenty-two records were included [ 3 , 4 , 5 , 6 , 8 , 9 , 10 , 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], from 25 screened records. Three were excluded because they did not meet criteria for precise diagnosis.…”