Nephrology Dialysis Transplantation, Vol 14, Issue 90003 53-57, Copyright © 1999 by Oxford University Press
L Noel
Focal and segmental glomerulosclerosis (SGS) is one of the most common and
non-specific patterns of glomerular injury encountered in human renal
biopsies. The primary form can be considered when there is a nephrotic
syndrome without other causes. The majority of authors agree that podocytes
play a role in the development of segmental glomerulosclerosis. The lesion
begins with cell hypertrophy, foot process effacement, cell body
attenuation, pseudocyst formation, cytoplasmic overload with reabsorption
droplets and finally detachment of the glomerular basement membrane (GBM).
When the GBM is denuded, it comes into contact with the parietal epithelium
and parietal epithelial cells will attach to the GBM, leading to a synechia
and, finally, sclerosis. Along this zone, parietal epithelial cells rest on
hyalin deposits. The origin of primary FSGS has not yet been elucidated.
Genetic, racial and developmental factors, macrophages, viral factors and
circulating factors are being explored and give encouraging results.
Key words: focal and segmental glomerulosclerosis;
podyctes; cytokines; genetic factors; viral factors; transplantation
ORIGINAL ARTICLES
Morphological features of primary focal and segmental glomerulosclerosis
INSERM U 507, Laboratoire de Pathologie Rénale, Hôpital Necker, 161 rue de Sévres, 65015 Paris, France
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