Immunotactoid (Microtubular) Glomerulopathy: An Entity Distinct From Fibrillary Glomerulonephritis?

Alpers, Charles E.

doi:10.1016/s0272-6386(12)70132-4

Cited by 102 publications

(55 citation statements)

References 21 publications

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“…De un lado, Alpers (14) propone considerar la glomerulopatía "inmunotactoide" como una entidad distinta de la glomerulonefritis fibrilar por su fuerte asociación a procesos linfoproliferativos y disproteinemias, a diferencia de lo que ocurre con ésta última.…”

Section: Discussionunclassified

“…Aunque se han descrito numerosas asociaciones con otras enfermedades, como procesos linfoproliferativos (14,15), mieloma (6,18), síndrome de Sjögren (6), vasculitis leucocitoclástica (19) y crioglobulinemia (20), la mayoría de los casos son idiopáticos (21). A favor de la patogenia múltiple de estas entidades, merece destacarse la comunicación de recientes casos de glomerulonefritis fibrilar y glomerulopatía inmunotactoide en pacientes con infección por el virus de la hepatitis C (21,22); en uno de los cuales se informó normalización de la función renal tras completar la terapia con interferón (22).…”

Section: Discussionunclassified

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Enfermedad de depósito glomerular: a propósito de un caso de glomerulonefritis fibrilar

Cantillo¹,

López

Andrade

2009

biomedica

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En el diagnóstico rutinario por biopsia renal encontramos enfermedades glomerulares que tienen depósitos estructurales fibrilares en la matriz extracelular del glomérulo, visibles por microscopía electrónica. La amiloidosis es la glomerulopatía más común con depósitos de estas características ultraestructurales. Sin embargo, hay otras glomerulopatías con depósitos similares, negativas con rojo Congo, pero positivas para inmunoglobulinas. La glomerulonefritis fibrilar es una entidad diagnóstica ampliamente reconocida e identificada en, aproximadamente, 0,5% a 1% de las biopsias de riñones nativos. Suele manifestarse por una insuficiencia renal progresiva con síndrome nefrótico-nefrítico e hipertensión arterial sistémica, no tiene tratamiento claramente establecido y su pronóstico es malo. Se describen las características clínicas e histológicas del primer caso de glomerulonefritis fibrilar idiopática informado en Colombia.Palabras clave: glomerulonefritis, síndrome nefrótico, inmunoglobulinas, insuficiencia renal, informes de casos. Glomerular deposition disease, regarding a case of fibrillary glomerulonephritisIn routine diagnosis for renal biopsy, glomerular diseases are encountered that, viewed by electron microscopy, reveal deposits with a fibrillary structure in the extracellular matrix of the glomeruli. Amyloidosis is the most common glomerulopathy that shows deposits with an ultrastructural fibrillary structure. However, other glomerulopathies have deposits with an ultrastructural fibrillary structure and which are negative for Congo-red stain, but positive for immunoglobulins.Fibrillary glomerulonephritis is a well-characterized disease, and clearly identified in approximately 0.5% to 1% of biopsies of native kidneys. These cases usually manifest themselves as severe renal insufficiencies with nephrotic-range proteinuria. No treatment regimes have been clearly established and the prognosis is poor. Herein, the clinical and histological characteristics are described for the first case of idiopathic fibrillary glomerulonephritis reported in Colombia.

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Section: Discussionunclassified

Enfermedad de depósito glomerular: a propósito de un caso de glomerulonefritis fibrilar

Cantillo¹,

López

Andrade

2009

biomedica

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“…More recently, two distinct glomerulopathies with electron-microscopic nonamyloid fibrillary deposits were described, namely, fibrillary glomerulonephritis (FGN) and IT [5]. The distinction between FGN and IT is based on morphological differences visible on electron microscopy [5][6][7]. In IT, parallel-arranged hollow microtubular glomerular deposits with diameters ranging from 16.8 to 90.0 nm are found.…”

Section: Discussionmentioning

confidence: 99%

Immunotactoid glomerulonephritis in a child with HIV infection: a case report

2007

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Renal disease is a common complication of human immunodeficiency virus (HIV) infection in adults. In children, however, HIV pathology of the gastrointestinal and respiratory tracts predominates, whereas renal disease is often an incidental finding. In this report, we describe a child with stage III HIV infection associated with immunotactoid glomerulonephritis (IT). The patient was referred for investigation of idiopathic nephrotic syndrome. Electron microscopy of his renal biopsy specimen revealed numerous electron-dense microtubular deposits, arranged in parallel fashion, consistent with a diagnosis of IT. He received highly active antiretroviral therapy (HAART) as well as corticosteroids and is currently in remission. To our knowledge, this is the first report of IT in a child.

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“…The proponents of subdividing ITG suggest that the diagnosis of ITG be reserved for cases with larger (Ͼ30 nM diameter), parallel microtubules ( Figure 2A) and that FGN be applied to cases with smaller (Յ30 nM diameter), randomly arranged fibrils ( Figure 2B) (9,10,13). The rationale for this subdivision is that the two morphologic categories have significantly different clinical implications (9,10,14,15).…”

Section: One Entity or Two?mentioning

confidence: 99%

“…The rationale for this subdivision is that the two morphologic categories have significantly different clinical implications (9,10,14,15). In a review of the literature in 1992, Alpers (13) first proposed that such a distinction was clinically important when he found that six (54.5%) of 11 patients with microtubules that were Ͼ30 nM in diameter had associated dysproteinemia or lymphoproliferative disorder compared with only one (1.2%) of 86 patients with smaller microtubules. In 1993, Fogo et al (10), on the basis of their own experience, found that patients with organized arrays of larger microtubules were more likely to have a hematopoietic disorder than patients with small, randomly oriented fibrils.…”

Section: One Entity or Two?mentioning

confidence: 99%