Go back to clinical information and images

Diagnosis: Focal and Segmental Glomerulosclerosis, Perihilar Variant

This variant is defined by the presence of at least one glomerulus with perihilar hyalinosis with or without sclerotic lesions at the glomerular vascular pole (perihilar) in more than 50% of glomeruli with segmental lesions. This form has been described in both primary FSGS and secondary adaptive forms stemming from nephron loss or glomerular hypertension (i.e., due to obesity, reflux nephropathy, hypertension, and sickle cell disease), usually accompanied by glomerular hypertrophy. In the adaptive conditions, reflex dilatation of the afferent arteriole leading to glomerular hypertension may cause particular stress on the perihilar segment. Foot process effacement is usually focal and relatively mild (Han MH, Kim YJ. Biomed Res Int. 2016;9375753. [PubMed link]).

The glomerular alteration (and proteinuria) in our case was clearly preceded by a long-standing systemic hypertension, then, we could also call it as "hypertensive nephropathy", however, this term is often used to speak of chronic scarring lesions with fibrosis, tubular atrophy, and nephroangiosclerosis assumed to be caused for chronic systemic arterial hypertension.

See the chapter: Focal and Segmental Glomerulosclerosis of our Tutorial.

Go back to clinical information and images

References

[Top]

Go back to clinical information and images