Clinicopathological analysis of glomerulopathy with fibronectin deposits (GFND): a case of sporadic, elderly-onset GFND with codeposition of IgA, C1q, and fibrinogen

Intern Med. 2013;52(15):1715-20. doi: 10.2169/internalmedicine.52.0046. Epub 2012 Mar 1.

Abstract

A 67-year-old Japanese man with recurrent nephrotic syndrome and impaired kidney function had a sporadic, elderly-onset case of glomerulopathy with fibronectin deposits. The daily urinary protein, serum albumin, blood urea nitrogen, and creatinine levels were 3.6 g/day, 2.7 g/dL, 19.5 mg/dL, and 1.70 mg/dL, respectively. Kidney biopsy samples were evaluated using electron microscopy and demonstrated membranoproliferative glomerulonephritis-like lesions with massive subendothelial depositions and no fibrillary structures. Immunofluorescent studies showed 1+ staining for IgA, C1q, and fibrinogen. Anti-fibronectin immunostaining demonstrated that the subendothelial deposits were positive for fibronectin. The administration of prednisolone and mizoribine improved the nephrotic syndrome.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age of Onset
  • Aged
  • Complement C1q / metabolism*
  • Fibrinogen / metabolism*
  • Fibronectins / metabolism
  • Glomerulonephritis, Membranoproliferative / drug therapy
  • Glomerulonephritis, Membranoproliferative / metabolism*
  • Glomerulonephritis, Membranoproliferative / pathology*
  • Humans
  • Immunoglobulin A / metabolism*
  • Kidney / metabolism
  • Kidney / pathology
  • Male
  • Prednisolone / therapeutic use
  • Ribonucleosides / therapeutic use
  • Treatment Outcome

Substances

  • Fibronectins
  • Immunoglobulin A
  • Ribonucleosides
  • mizoribine
  • Complement C1q
  • Fibrinogen
  • Prednisolone

Supplementary concepts

  • Glomerulopathy with fibronectin deposits