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Is mesangial hypercellularity with glomerular immaturity a variant of glomerulosclerosis?

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Abstract

Our aim was to correlate an immunohistochemical pattern of selected podocyte cytoskeleton-associated proteins in children diagnosed with focal segmental glomerulosclerosis (FSGS) and diffuse mesangial proliferation accompanied by glomerular immaturity (Im-DMP) with the clinical courses of both diseases. The material included 33 renal biopsies obtained from children diagnosed with DMP with or without signs of glomerular immaturity (ten and 15 participants, respectively) or FSGS (eight patients). Ezrin, podocalyxin, synaptopodin and nephrin expression was evaluated by immunohistochemical assay. A positive reaction for ezrin, podocalyxin, synaptopodin and nephrin was observed in the most superficial, continuous ‘layer’ of podocytes in Im-DMP patients. This distribution closely mimicked the immunohistochemical pattern observed in FSGS. The severe initial course of Im-DMP was transient. Resistance to steroids (six children) and renal insufficiency (two patients) in these subjects subsided, whilst, in the FSGS patients, the resistance to steroids recognized in all the children and the renal insufficiency diagnosed in three of them were still present. Mimicry between the immunohistochemical pattern of glomerular immaturity in DMP and focal segmental glomerulosclerosis might explain the severe initial course of this nephrotic syndrome in children. The transient clinical character of the former may also indicate that it is not a variant of FSGS.

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Notes

  1. Parts of this investigation were reported at the IVth Conference of the Polish Association of Paediatric Nephrology in Cracow, Poland, 20–22 April 2006, published in [20].

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Acknowledgements

We are indebted to Mrs. S. Bramke and Mrs. A. Neisser, University of Technology Dresden, Germany, for their skilful technical work, to Dr. M. G. Farquhar, San Diego, CA, USA, for the generous donation of the podocalyxin antibody, and to Prof. G. Shaw for his assistance with the English text. This study was supported by the State Committee for Scientific Research (KBN, grant no. 2PO5E 07130).

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Poznan University of Medical Sciences, ul. Szpitalna 27/33, 60-572, Poznan, Poland

    Danuta Ostalska-Nowicka & Jacek Zachwieja

  2. Departments of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland

    Michal Nowicki

  3. Department of Clinical Pathomorphology, Poznan University of Medical Sciences, Poznan, Poland

    Elzbieta Kaczmarek

  4. Department of Anatomy, Department of Neuroradiology, Technical University, Dresden Medical School, Dresden, Germany

    Martin Witt

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  1. Danuta Ostalska-Nowicka
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  2. Jacek Zachwieja
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  3. Michal Nowicki
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  4. Elzbieta Kaczmarek
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  5. Martin Witt
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Correspondence to Danuta Ostalska-Nowicka.

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Ostalska-Nowicka, D., Zachwieja, J., Nowicki, M. et al. Is mesangial hypercellularity with glomerular immaturity a variant of glomerulosclerosis?. Pediatr Nephrol 22, 674–683 (2007). https://doi.org/10.1007/s00467-006-0407-9

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  • DOI: https://doi.org/10.1007/s00467-006-0407-9

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