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  • Title: [Case of a focal segmental glomerulosclerosis collapsing variant associated with a hypertrophic column of Bertin].
    Author: Ishida T, Shimazu K, Takaori K, Mori K, Yorifuji S, Nishiguchi K, Eguchi E, Koshikawa M, Tanaka A, Kuwahara T.
    Journal: Nihon Jinzo Gakkai Shi; 2011; 53(1):53-9. PubMed ID: 21370578.
    Abstract:
    A 59-year-old Japanese man admitted to our hospital complaining of anasarca, body weight gain, and elevation of blood pressure. Serum creatinine(Cre), albumin(Alb), cholesterol(chol), and urinary protein were 1.3 mg/dL, 2.5 g/dL, 527 mg/dL, and 10 g/gCr, respectively. An abdominal echography showed a renal mass, which was diagnosed to be a hypertrophic column of Bertin by enhanced CT. His serum Cre and Alb had worsened to 1.6 mg/dL and 1.7 g/dL, respectively, and a renal biopsy was performed. The results showed a segmental sclerotic lesion associated with hypertrophy and proliferation of podocytes in several glomeruli, hence we diagnosed a focal segmental glomerulosclerosis collapsing variant. After steroid pulse therapy and LDL apheresis, his serum Cre level had decreased to 1.1 mg/dL and the urinary protein level to 2.5 g/gCr. Patients with a focal segmental glomerulosclerosis collapsing variant are poor responders to standard therapies, and have a very poor prognosis. For this case, combined steroid pulse and LDL apheresis therapy was effective.
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