Korean J Nephrol.  2007 Jul;26(4):480-484.

A Case of Idiopathic Nodular Glomerulosclerosis Related to Hypertension and Smoking

• Park GH
• Choi WG
• Um WH
• Kwon SH
• Lee SW
• Song JH
• Lee SW
• Han JY
• Kim MJ

Abstract

A 39-year-old man with a history of hypertension for 10 years and 10 pack-years smoking, was admitted with dyspnea and generalized edema. On admission, renal insufficiency accompanied with nephrotic syndrome was diagnosed. Even on careful examination including history, blood chemistry test, and fundoscopic examination, no clinical evidence of diabetes was found. Renal biopsy findings, which strongly resembled that of diabetic nodular glomerulosclerosis in microscopic features, showed glomerular hypertrophy and nodular mesangeal sclerosis. Additional immunohistochemistry and ultrastructural investigations excluded other possible diseases that should be differentiated; membranoproliferative glomerulonephritis, thrombotic microangiopathy, amyloidosis, monoclonal immunoglobulin deposition disease, fibrillary glomerulonephritis, and immunotactoid glomerulopathy. Idiopathic nodular glomerulosclerosis is histopathologically similar to nodular diabetic glomerulosclerosis but is unusually developed in persons with hypertension and smoking history. Though there were three reports about cases of nodular glomerulosclerosis in the Korean literature, the cases were related to hepatitis B virus or diabetic retinopathy without overt diabetes. We report a rare case of idiopathic nodular glomerulosclerosis that was related to hypertension and smoking without other medical history.

Keyword

Nodular glomerulosclerosis; Hypertension; Smoking

MeSH Terms

Adult
Amyloidosis
Biopsy
Chemistry
Diabetic Nephropathies*
Diabetic Retinopathy
Dyspnea
Edema
Glomerulonephritis
Glomerulonephritis, Membranoproliferative
Hepatitis B virus
Humans
Hypertension*
Hypertrophy
Immunoglobulins
Immunohistochemistry
Nephrotic Syndrome
Renal Insufficiency
Sclerosis
Smoke*
Smoking*
Thrombotic Microangiopathies
Immunoglobulins
Smoke