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Lipoprotein glomerulopathy-like disease in a patient with type III hyperlipoproteinemia due to apolipoprotein E2 (Arg158 Cys)/3 heterozygosity

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Abstract

A 77-year-old woman developed nephrotic syndrome associated with type III hyperlipoproteinemia (III HLP) and increased apolipoprotein E (apo E). Apo E analysis disclosed E2/E3 heterozygosity in phenotypic and genotypic expressions, without any other mutations. A renal biopsy showed intraluminal and subendothelial thrombus-like deposits in the dilated capillary loops of the glomerulus that stained positive for lipids and apo E. Electron microscopy revealed tiny granular particles in the capillary lumina, as well as between the glomerular basement membrane and the endothelial cells. It was therefore concluded that III HLP associated with apo E2/E3 heterozygosity could induce lipoprotein glomerulopathy-like disease and nephrotic syndrome.

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Authors and Affiliations

  1. Division of Nephrology and Rheumatology, First Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-0061, Japan

    Miho Karube, Kimimasa Nakabayashi, Ken Yoshihara & Akira Yamada

  2. Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan

    Yasunori Fujioka

  3. Division of Cardiology, Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan

    Akira Matsunaga

  4. Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan

    Takao Saito

Authors
  1. Miho Karube
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  2. Kimimasa Nakabayashi
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  3. Yasunori Fujioka
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  4. Ken Yoshihara
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  5. Akira Yamada
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  6. Akira Matsunaga
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  7. Takao Saito
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Correspondence to Kimimasa Nakabayashi.

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Karube, M., Nakabayashi, K., Fujioka, Y. et al. Lipoprotein glomerulopathy-like disease in a patient with type III hyperlipoproteinemia due to apolipoprotein E2 (Arg158 Cys)/3 heterozygosity. Clin Exp Nephrol 11, 174–179 (2007). https://doi.org/10.1007/s10157-007-0469-4

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  • DOI: https://doi.org/10.1007/s10157-007-0469-4

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