Focal Segmental Glomerulosclerosis
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Introduction
FSG has risen to include 25% of adult nephropathies. It is a clinical-pathological syndrome describing mulitple disease entities. Clinicially, there is proteinuria. Pathologically, focal segmental glomerular consolidation or scarring.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Causes include:
- altered cellular immunity
- IV heroin use
- AIDS
- reaction to chronic proteinuria
- idiopathic
There may also be an association with obesity.
Pathophysiology
Injury is caused by unknown entities in most cases, and inflammation ultimately leads to collagen scarring. Hyaline deposits can be seen in glomeruli.
Signs and Symptoms
- history
- physical exam
History
Hypertension is a later presentation.
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Proteinuria or nephrotic syndrome are frequent presenting conditions, with hematuria later developing.
Diagnostic Imaging
Differential Diagnosis
Treatments
Treatment can include corticosteroids, cyclophosphamide, and cyclosporin.
Dialysis and transplantation may also be needed.
Consequences and Course
Most people with FSGS develop chronic renal failure within 10 years.
Resources and References
Topic Development
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