Summary
Morphometrical and clinical investigations were performed in 34 patients with the so-called hypercellular form of focal glomerulosclerosis (FGS), i.e., a form showing clear diffuse mesangial hypercellularity beside focal sclerosis with the light microscope. This form was compared with focal glomerulosclerosis without remarkable mesangial hypercellularity, with mild mesangioproliferative glomerulonephritis (gn), as well as with normal kidneys.
The results were as follows:
-
1.
Morphometrically both the increase in relative mesangial volume as well as in mesangial cell count is statistically significant in the hypercellular form compared with the nonhypercellular form and with controls. Comparison with mild mesangioproliferative gn shows no difference.
-
2.
Even the so-called nonhypercellular form contains more mesangial matrix and mesangial cells than the controls.
-
3.
The frequency of the hypercellular form is higher in males and in older patients.
-
4.
All of our patients with hypercellular FGS had at the time of biopsy manifested nephrotic syndrome. The frequency of additional clinical symptoms (hematuria, hypertension, renal insufficiency) corresponds with the nonhypercellular form, but is different in mild mesangioproliferative gn.
-
5.
Therapeutic response and prognosis is worse in the hypercellular form.
The hypercellular form of FGS has to be separated from the nonhypercellular form as a defined entity.
Similar content being viewed by others
References
Barnett, H. L.: A report of the international study of kidney disease in children. Clin. Res. 21, 737 (1973)
Bohle, A., Fischbach, H., Wehner, H., Woerz, U., Edel, H. H., Kluthe, R., Scheler, F.: Minimal change lesion with nephrotic syndrome and focal glomerular sclerosis. Clin. Nephrol. 2, 52–58 (1974)
Bohle, A., Buchborn, E., Edel, H. H., Renner, E., Wehner, H.: Glomerulonephritis in children and adults. Abstr. V. Intern. Congr. Nephrol. Mexico City 1972
Bohle, A., Fischbach, H.: Klassifikation und Prognose der Glomerulonephritis. Aktuelle Diagnostik von Nierenerkrankungen, S. 104–114. Stuttgart: Thieme 1974
Cameron, J. S., Ogg, C. S., Turner, D. A., Weller, R. O.: Focal glomerulosclerosis. In “Glomerulonephritis” ed. by Kincaid-Smith [8], pp. 249–261. New York: John Wiley and Sons 1973
Churg, J., Habib, R., White, R. H. R.: A report of international study of kidney disease in children: pathology of the nephrotic syndrome in childhood. Lancet 1970 I, 1299–1302
Editorial (unsigned): Focal glomerulosclerosis. Lancet 1972 II, 367
“Glomerulonephritis” ed. by Kincaid-Smith, P., T. H. Mattew and E. L. Becker. New York: John Wiley and Sons 1973
Habib, R.: Focal glomerular sclerosis. Editorial. Kidney International 4, 355–361 (1973)
Habib, R., Gubler, M. C.: Focal sclerosing glomerulonephritis. In “Glomerulonephritis” ed. by Kincaid-Smith [8],, pp. 263–278. New York: John Wiley and Sons 1973
Habib, R., Kleinknecht, C.: The primary nephrotic syndrome of childhood. Classification and clinicopathologic study of 406 cases. Path. Ann. 6, 417–473 (1971)
Hara, M.: Persistent glomerular changes after acute glomerulonephritis: A histometrical study of 34 autopsy cases. Beitr. Path. 147, 133–144 (1972)
Hayslett, J. P., Krassner, L. S., Bensch, K. G., Kashgarian, M., Epstein, F. H.: Progression of lipoid nephrotis to renal insufficiency. New Engl. J. Med. 281, 181–187 (1969)
Hyman, L. R., Burkholder, P. M.: Focal sclerosing glomerulonephropathy with segmental hyalinosis: A clinicopathologic analysis. Lab. Invest. 28, 533–544 (1973)
Kincaid-Smith, P., Hobbs, J. B.: Glomerulonephritis. A classification based on morphology with comments on the significance of vessel lesions. Med. J. Aust. 16, 1397 (1972)
Kashgarian, M., Hayslett, J. P., Siegel, N. J.: Lipoid nephrosis and focal sclerosis. Distinct entities or spectrum of disease. Nephron 13, 105–108 (1974)
Mc Govern, V. J., Lauer, C. S.: Focal sclerosing glomerulonephritis. In “Glomerulonephritis” ed. by Kincaid-Smith [8],, pp. 223–230. New York: John Wiley and Sons 1973
Moncrieff, M. W., White, R. H. R., Glasgow, E. F., Winterborn, M. H., Cameron, J. S., Ogg, C. S.: The familial nephrotic syndrome: II. A clinicopathological study. Clin. Nephrol. 1, 220–229 (1973)
Nagi, A. H., Alexander, F., Lannigan, R.: Light and electron microscopical studies of focal glomerular sclerosis. J. clin. Path. 24, 846–850 (1971)
Rumpelt, H. J., Thoenes, W.: Intraglomerular (immune) deposits in focal and segmental sclerosing glomerulopathy (-nephritis) (focal sclerotic lesion, hyalinose segmentaire et focale). Clin. Nephrol. 1, 367–371 (1973)
Rumpelt, H. J., Thoenes, W.: Fokal-sclerosierende Glomerulopathie (Glomerulonephritis), ein diffuser Prozeß. Klin. Wschr. 50, 1143–0146 (1972)
Siegel, N. J., Kashgarian, M., Spargo, B. H., Hayslett, J. P.: Minimal change and focal sclerotic lesions in lipoid nephrosis. Nephron 13, 125–137 (1974)
Wehner, H.: Zur quantitativen Pathomorphologie des Glomerulum der menschlichen Niere. Habilitationsschrift Tübingen 1972
White, R. H. R., Glasgow, E. F., Mills, R. J.: Focal glomerulosclerosis in childhood. In “Glomerulonephritis” ed. by Kincaid-Smith [8],, pp. 231–248. New York: John Wiley and Sons 1973
Author information
Authors and Affiliations
Additional information
With kind support of the Deutsche Forschungsgemeinschaft
Rights and permissions
About this article
Cite this article
Grand, KE., Hara, M. & Bohle, A. Diffuse mesangial cell proliferation in focal sclerosing glomerulonephritis. Virchows Arch. A Path. Anat. and Histol. 370, 297–305 (1976). https://doi.org/10.1007/BF00445775
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00445775