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İdiyopatik Nodüler Glomerüloskleroz: Olgu Sunumu

Idiopathic Nodular Glomerulosclerosis: A Case Report

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2012
DOI: 
DOI 10.5262/tndt.2012.1001.17

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Nodular glomerulosclerosis, although once identified as a histopathological diagnosis identical with diabetes mellitus (DM), can be seen in many diseases like membranoproliferative glomerulonephritis, amyloidosis, fibrillary and immunotactoid glomerulopathy. Idiopathic nodular glomerulosclerosis (ING) can be diagnosed by exclusion of these diseases. Medical history, serology and immunohistochemical and electron microscopical examination of renal biopsy are helpful also. ING has been related with smoking and hypertension in recent studies. Herein, we present a case of ING who is smoker and had hypertension for seven years. A 43 year-old man with swollen ankles had laboratory examinations showing creatinine:2.1mg/ dl, albumin:2.9g/l and daily proteinuria:4380mg. Hepatitis B surface antigen was positive. DM was excluded. Renal size was normal by ultrasound. Renal biopsy contained 30 glomeruli, 18 of which were globally sclerotic. Mesangial nodular lesions were striking in the others. With these findings we diagnosed ING. As a result, relation of ING with smoking and hypertension has been highlighted by recent studies. ING should be considered if nodular glomerulosclerosis is identified in renal biopsy of a smoker nondiabetic with hypertension. Although hepatitis B infection is among the classical secondary reasons of nodular glomerulosclerosis; co-existing serum hepatitis B surface antigen positivity has been reported in a few case reports.
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Abstract (Original Language): 
Nodüler glomerüloskleroz önceleri diyabetes mellitus (DM) ile özdeşleştirilen bir histopatolojik tanı olmakla birlikte, membranoproliferatif glomerülonefrit, amiloidoz, fibriler ve immüntaktoid glomerülopati gibi birçok hastalıkta görülebilir. İdiyopatik nodüler glomerüloskleroz (İNG) tanısı bu hastalıkların dışlanmasıyla koyulur. Ayırıcı tanıda anamnez, seroloji ve böbrek biyopsisinin immünhistokimyasal ve elektron mikroskopik incelemesi de yardımcı olur. Son çalışmalarda İNG, sigara kullanımı ve hipertansiyon ile ilişkilendirmektedir. Bu yazıda aktif sigara içicisi olan ve yedi senedir hipertansif bir İNG olgusu sunulmuştur. Kırk üç yaşında erkek hastanın ayaklarda şişlik şikayetiyle yapılan tetkiklerinde kreatinin: 2,1 mg/dl, albümin: 2,9 g/dl ve günlük proteinüri: 4380 mg bulundu. Hepatit B yüzey antijeni pozitifti. DM tanısı dışlandı. Ultrasonografi ile böbrek boyutları normal sınırlarda idi. Böbrek biyopsisinde 30 glomerülün 18’i global sklerotik idi. Diğer glomerüllerde faklı büyüklükte nodüler lezyonlar dikkati çekti. Bu bulgularla İNG tanısı koyuldu. Sonuç olarak İNG’nin sigara kullanımı ve hipertansiyon ile birlikteliği son yayınlarda vurgulanmaktadır. Diyabetik olmayan, hipertansif ve sigara kullanan bir hastanın böbrek biyopsisinde nodüler glomerüloskleroz saptanırsa İNG düşünülmelidir. Hepatit B infeksiyonu nodüler glomerülosklerozisin klasik sekonder nedenleri arasında sayılmamakla birlikte, eşlik eden serum hepatit B yüzey antijeni pozitifliği birkaç İNG olgu sunumunda bildirilmiştir.
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  • 1
95-97
  • Turkish

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