Focal and segmental glomerulosclerosis (FSGS) is a disease characterized de la Nieta MD, Arias LF, et al., Glomeruloesclerosis focal y segmentaria familiar. Download scientific diagram | Esclerosis Focal y Segmentaria con proliferación mesangial from publication: Nephrotoxicity after recreational drug use. N Engl J Med. Dec 22;(25) doi: /NEJMra Focal segmental glomerulosclerosis. D’Agati VD(1), Kaskel FJ, Falk RJ.
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Membranous glomerulopathy can occur at any age. Engrosamiento de la Membrana basal y spikes meteramia de plata IF: In the future, when we will have more knowledge of the etiology and physiopathogenesis of the disease, we will be able to distinguish better the different forms from the disease. However, CG is frequently an aggressive disease, with massive proteinuria and rapidly progressive renal disease.
Podocin, expressed exclusively in the glomerular podocyte, is an integral membrane protein located on the foot processes adjacent to the slit diaphragms that play a critical role in regulating hydraulic flow and protein filtration from the plasma space into the urinary space. Activated PECs migrate along adhesion to the glomerular tuft and may also contribute to the progression of sclerosis.
Curso Superior AMA Modulo Renal 2016
Mutations in this protein associated with FSGS result in increased affinity for actin binding, formation of intracellular aggregates, and decreased protein half-life. Although the mechanism has not been clear, it is presumably due to some partial temporary obstruction of segmentxria veins to the kidney, which is where the blood goes out of the kidney. There is predilection by Afro-American patients. It does appear that either they are in a partial remission or their disease is relatively mild and they don’t need a lot of aggressive treatment.
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We hypothesize segmentadia secondary FSGS results from a combination of postadaptive glomerular changes driven by increased lean body mass and potential direct nephrotoxic effects of anabolic steroids. Immunofluorescence microscopy allows the specific identification of, in particular, abnormal esckerosis that can cause certain kinds of glomerular disease but don’t cause others.
They are also producing this capillary wall thickening, and there can be substantial injury to the glomerulus. As you know, antibodies are molecules we normally use to fight off foreign invaders. Podocyte hypertrophy and hyperplasia are typically identified overlying these lesions, but are not required features.
The proximal tubular pole must be identified in the defining glomerulus. You can see on the far right just one capillary loop; on the left, you can see there are many loops there. This material probably represents accumulation of serum proteins. High-dose oral cyclosporin therapy for recurrent focal segmental glomerulosclerosis in children.
Recurrence of proteinuria following renal transplantation in congenital nephrotic syndrome of the Finnish type. Although there is considerable controversy with respect to the meaning and definition of these variants, the classification tries to define concepts than allow a same language among all the nephropathologists and nephrologists of the world.
In addition, if there are lesions in perihilar segments the tip variant is excluded, having in consideration the peripheral nature of the lesions in the tip variant. So of those millions of glomeruli you’ve got, only some have this lesion. In patients rsclerosis HIV infection and this variant is frequent to find tubuloreticular inclusions in endothelial cells electron microscopy that are not identified in other collapsing lesions not associated to HIV; this feature is not exclusive of HIV-associate nephropathy and may be also identified in other diseases like lupus nephritis.
Management plan for failure of initial treatment As I mentioned, somewhere between 20 and 40 percent of patients will have a complete remission with steroid therapy. Remember that in focal segmental glomerulosclerosis, in areas that weren’t scarred there was no staining.
Some of them esclrosis associated with clinical characteristics or demographic aspects, or a more or less aggressive evolution. In the case of the microphotography we found segmental and focal sclerosing lesions, NOS type, in 4 of 18 glomeruli, and only focak the one of the photo with features of hypercellular variant. There can be mesangial hypercellularity, podocyte hypertrophy-hyperplasia, or glomerulomegaly. The protein expressed by this gene is expressed in podocytes where it interacts with fyn and synaptopodin.
Protease activity of plasma hemopexin. Intracytoplasmic lipid vacuoles are observed.
The adjacent tuft presents solidification, with diminution or loss of capillary lumens. Anteced, de HTA leve Sin antec familiares de enf. The receptor for urokinase type plasminogen activator polarizes expression of the protease to the leading edge of migrating monocytes and promotes degradation of enzyme inhibitor complexes.
In the segments with lesion is identified, very frequently, deposits of IgM and Wsclerosis. Cyclosporin segkentaria idiopathic glomerular disease associated with the nephrotic syndrome: There is the thickening of the capillary wall, sort of the membranous component we just looked at with membranous glomerulopathy, but there is also hypercellularity, including mesangial proliferation.
Also, sometimes at the glomerular level, and maybe even in the whole body, there is an increase in blood pressure that can force more protein across the wall, which may be why certain antagonists of increased pressure, such as ACE inhibitors, can reduce the proteinuria in certain patients.
Glomerular tip changes in childhood segmeentaria change nephropathy. The actin escleorsis of kidney podocytes is a direct target of the antiproteinuric effect of cyclosporine A. The cells occasionally manifest apoptosis, producing pyknotic or karyorrhectic debris.
Glomeruloesclerosis Focal y Segmentaria en el Adulto – ppt descargar
Shortly after the muted gene in the autosomal recessive steroid resistant NS was discovered: Although oncologic treatment regimens included vincristine for four patients, doxorubicin for five patients, cisplatin for two patients, and total-body irradiation for one patient, the only agent common to all patients was pamidronate Escllerosis.
Firstly, protein aggregation may have a toxic effect on the podocyte. This alteration must not be confused with the cellular variant in the present classification. Attempts to identify pathogenic mechanisms in CG have raised a number of hypotheses; however, the mechanisms through which these disorders lead to diffuse podocyte injury are poorly understood. There are structural changes that take place within the glomerulus when this happens in different diseases, and this is what we are going to focus on to identify the different types of disease that cause the nephrotic syndrome.
Focal segmental glomerulosclerosis
The light microscopy looks usually completely normal. Her past medical history was significant only for mild high blood pressure, controlled with a thiazide diuretic. They are normal effects of living in our environment.
Immunohistochemistry showed that some podocytes in FSGS lesions had absent or diminished expression of the podocyte-specific epitopes synaptopodin and p57, reflecting dedifferentiation, and had acquired expression of cytokeratin and PAX2, reflecting a immature fetal phenotype.
But with time, often it can progress. Current views on collapsing glomerulopathy. Large cells, with clear or vacuolated cytoplasm and small nuclei.