Clinicopathological Analysis of Glomerulopathy with Fibronectin Deposits (GFND): A Case of Sporadic, Elderly-Onset GFND with Codeposition of IgA, C1q, and Fibrinogen

Masabumi Yoshino; Naoto Miura; Takahiro Ohnishi; Keisuke Suzuki; Wataru Kitagawa; Kazuhiro Nishikawa; Hirokazu Imai

doi:10.2169/internalmedicine.52.0046

CASE REPORTS

Clinicopathological Analysis of Glomerulopathy with Fibronectin Deposits (GFND): A Case of Sporadic, Elderly-Onset GFND with Codeposition of IgA, C1q, and Fibrinogen

Masabumi Yoshino, Naoto Miura, Takahiro Ohnishi, Keisuke Suzuki, Wataru Kitagawa, Kazuhiro Nishikawa, Hirokazu Imai

Author information

Masabumi Yoshino
Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan
Naoto Miura
Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan
Takahiro Ohnishi
Division of Nephrology, Ise Red Cross Hospital, Japan
Keisuke Suzuki
Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan
Wataru Kitagawa
Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan
Kazuhiro Nishikawa
Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan
Hirokazu Imai
Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan

Keywords: nephrotic syndrome, MPGN-like lesion, fibronectin, prednisolone, mizoribine

JOURNAL OPEN ACCESS

2013 Volume 52 Issue 15 Pages 1715-1720

DOI https://doi.org/10.2169/internalmedicine.52.0046

Details

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.

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