1
|
Guillaume E, Zacharopoulou M, Reynolds B, Aresu L, Lobjois L, Bleuart C, Bourgès-Abella N, Delverdier M, Lucas MN, Lavoué R, Gaide N. Additional Value of Second Harmonic Generation Microscopy in the Diagnosis of Feline Collagen Type III Glomerulopathy. J Comp Pathol 2021; 188:37-43. [PMID: 34686276 DOI: 10.1016/j.jcpa.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/10/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022]
Abstract
A 1.5-year-old neutered female Domestic Shorthair cat was euthanized after the diagnosis of end-stage protein-losing nephropathy associated with the onset of nephrotic syndrome. At necropsy, both kidneys were diffusely pale and swollen with a granular cortex. Histologically, glomeruli had diffuse global mesangial and capillary wall expansion by homogeneous pale eosinophilic material. This material was Congo red negative, blue with Masson's trichrome stain, weakly positive with periodic acid-Schiff stain, bright red with Picrosirius red and birefringent under polarized light. Transmission electron microscopy and second harmonic generation (SHG) microscopy revealed mesangial and subendothelial collagen fibril deposition. Type III collagen deposition was confirmed by immunohistochemistry. This study provides an original and complete description of feline collagen type III glomerulopathy and emphasizes the possibility of directly diagnosing glomerular collagen deposition on unstained slides through SHG microscopy.
Collapse
Affiliation(s)
- Elise Guillaume
- Laboratory of Anatomic Pathology and Histology, École Nationale Vétérinaire de Toulouse (ENVT), University of Toulouse, Toulouse, France
| | - Maria Zacharopoulou
- Laboratory of Anatomic Pathology and Histology, École Nationale Vétérinaire de Toulouse (ENVT), University of Toulouse, Toulouse, France
| | | | - Luca Aresu
- Department of Veterinary Sciences, University of Torino, Grugliasco, Italy
| | - Lhorane Lobjois
- Cell Imaging Facility, Toulouse Institute for Infectious and Inflammatory Diseases, National Institute of Health and Medical Research (INSERM), Toulouse, France
| | - Céline Bleuart
- Laboratory of Anatomic Pathology and Histology, École Nationale Vétérinaire de Toulouse (ENVT), University of Toulouse, Toulouse, France
| | - Nathalie Bourgès-Abella
- Laboratory of Anatomic Pathology and Histology, École Nationale Vétérinaire de Toulouse (ENVT), University of Toulouse, Toulouse, France; Regional Center for Functional Exploration and Experimental Resources (CREFRE), Université de Toulouse, INSERM, Université Toulouse III Paul Sabatier (UPS), ENVT, Toulouse, France
| | - Maxence Delverdier
- Laboratory of Anatomic Pathology and Histology, École Nationale Vétérinaire de Toulouse (ENVT), University of Toulouse, Toulouse, France; Interactions Hôtes - Agents Pathogènes (IHAP), Université de Toulouse, National Research Institute for Food, Agriculture and the Environment (INRAE), ENVT, Toulouse, France
| | - Marie-Noëlle Lucas
- Laboratory of Anatomic Pathology and Histology, École Nationale Vétérinaire de Toulouse (ENVT), University of Toulouse, Toulouse, France
| | - Rachel Lavoué
- Digestive Health Research Institute (IRSD), Université de Toulouse, INSERM, INRAE, ENVT, UPS, Toulouse, France; Université de Toulouse, ENVT, Toulouse, France
| | - Nicolas Gaide
- Laboratory of Anatomic Pathology and Histology, École Nationale Vétérinaire de Toulouse (ENVT), University of Toulouse, Toulouse, France; Interactions Hôtes - Agents Pathogènes (IHAP), Université de Toulouse, National Research Institute for Food, Agriculture and the Environment (INRAE), ENVT, Toulouse, France.
| |
Collapse
|
2
|
Jdiaa SS, Moeckel GW, Kfoury HM, Medawar WA, Abu-Alfa AK. Collagenofibrotic glomerulopathy in a kidney transplant recipient: A first report. Am J Transplant 2021; 21:1948-1952. [PMID: 33206467 DOI: 10.1111/ajt.16399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 10/26/2020] [Accepted: 11/06/2020] [Indexed: 01/25/2023]
Abstract
Collagenofibrotic glomerulopathy (CG) is a rare disease characterized by the deposition of collagen type 3 fibrils in the glomeruli. Patients may have proteinuria, hematuria, and/or renal dysfunction. CG is considered a progressive disease with variable rates of progression. The definitive diagnosis is made by electron microscopy with the presence of characteristic subendothelial and mesangial curved, comma-like, banded collagen type 3 fibers of 40-65 nm periodicity. We are reporting the first case of CG in a kidney transplant recipient with kidney disease of unknown cause.
Collapse
Affiliation(s)
- Sara S Jdiaa
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Gilbert W Moeckel
- Division of Renal Pathology and Electron Microscopy, Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Hala M Kfoury
- Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Walid A Medawar
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ali K Abu-Alfa
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
3
|
Miyake M, Katayama K, Ehara T, Sado Y, Nawa S, Murata T, Mizutani Y, Joh K, Ito M, Dohi K. Collagenofibrotic Glomerulopathy. Intern Med 2021; 60:911-915. [PMID: 33055489 PMCID: PMC8024945 DOI: 10.2169/internalmedicine.6090-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Collagenofibrotic glomerulopathy or LMX1B-associated nephropathy is a rare disease in which type III collagen accumulates in the glomeruli. We herein report a 64-year-old Japanese woman with an elevated serum creatinine level and persistent proteinuria for 7 years. An electron microscopic study using tannic acid showed curved and frayed collagen fibers within mesangial and subendothelial regions compatible with type III collagen depositions. The distribution of type IV collagen α1-6 chains was normal. Since no pathogenic mutations were identified in the LMX1B gene, she was diagnosed with collagenofibrotic glomerulopathy and treated with angiotensin II receptor blocker and calcium antagonist to control her blood pressure.
Collapse
Affiliation(s)
- Masato Miyake
- Department of Nephrology, Yokkaichi Hazu Medical Center, Japan
| | - Kan Katayama
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Takashi Ehara
- Department of Histopathology, Shinshu University School of Medicine, Japan
| | - Yoshikazu Sado
- Division of Immunology, Shigei Medical Research Institute, Japan
| | - Shunpei Nawa
- Department of Nephrology, Yokkaichi Hazu Medical Center, Japan
| | - Tomohiro Murata
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | | | - Kensuke Joh
- Department of Pathology, The Jikei University School of Medicine, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| |
Collapse
|
4
|
Matthai SM, Mohapatra A, Duhli N, David VG, Varughese S. Collagenofibrotic glomerulopathy - A rare disease diagnosed with the aid of transmission electron microscopy. INDIAN J PATHOL MICR 2020; 63:S47-S49. [PMID: 32108627 DOI: 10.4103/ijpm.ijpm_341_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Collagenofibrotic glomerulopathy (CFG) is a rare idiopathic kidney disease characterized by abnormal deposition of atypical Type III collagen fibers in the glomerulus causing subendothelial and mesangial expansion, manifesting as progressive renal dysfunction accompanied by proteinuria. The majority of CFG cases reported in literature are from Japan where this disease entity was initially recognized. There is an increased awareness and diagnosis of this rare renal disease in India with the recent increase in utilization of electron microscopy (EM) in clinical diagnostic settings. We describe a 28-year-old Bangladeshi woman who presented with hypertension and nephrotic range proteinuria not amenable to treatment with steroids and cyclophosphamide, whose renal biopsy demonstrated diagnostic ultrastructural features of CFG. This illustrative case is presented to highlight the role of EM analysis for diagnostic accuracy in renal biopsy evaluation in addition to demonstrating the unusual renal biopsy findings of this rare entity.
Collapse
Affiliation(s)
- Smita Mary Matthai
- Department of GI Sciences, Central Electron Microscopy Facility, Wellcome Trust Research Laboratory, Vellore, Tamil Nadu, India
| | - Anjali Mohapatra
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Neelaveni Duhli
- Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinoi G David
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
5
|
Davis KL, Burnum AL, Beck JA, Kirejczyk SGM, Miller MA, Sola MF, Brown CA. Diagnosis of Collagen Type III Glomerulopathy Using Picrosirius Red and PASH/Masson's Trichrome Stain. Vet Pathol 2020; 57:675-680. [PMID: 32880237 DOI: 10.1177/0300985820934111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Canine collagen type III glomerulopathy (Col3GP) is a rare juvenile nephropathy in which irregular type III collagen fibrils and fibronectin accumulate in glomerular capillary walls and the mesangium. Necropsy findings were reviewed from 5 puppies diagnosed with Col3GP at 6 to 18 weeks of age. Histologically, with hematoxylin and eosin stain, the glomerular capillary walls and mesangium were diffusely and globally expanded by homogeneous pale eosinophilic material. Ultrastructurally, the subendothelial zone and mesangium were expanded by fibronectin and cross-banded collagen type III fibrils, diagnostic of Col3GP. Two additional stains were employed to identify the material within glomeruli as fibrillar collagen using light microscopy. In all 5 cases, the material was red with picrosirius red and birefringent under polarized light, and was blue with periodic acid-Schiff/hematoxylin/trichrome (PASH/TRI), thereby identifying it as fibrillar collagen. Based on these unique staining characteristics with picrosirius red and PASH/TRI, Col3GP may be reliably diagnosed with light microscopy alone.
Collapse
Affiliation(s)
- Katelin L Davis
- 311308Purdue University, West Lafayette, IN, USA.,National Cancer Institute, Comparative Biomedical Scientist Training Program, Bethesda, MD, USA
| | | | - Jessica A Beck
- 311308Purdue University, West Lafayette, IN, USA.,National Cancer Institute, Comparative Biomedical Scientist Training Program, Bethesda, MD, USA
| | | | | | - Mario F Sola
- 311308Purdue University, West Lafayette, IN, USA
| | | |
Collapse
|
6
|
Agarwal R, Baid R, Mukhopadhyay J. Collagenofibrotic Glomerulopathy: Report a Rare Case. ARCHIVES OF IRANIAN MEDICINE 2020; 23:409-411. [PMID: 32536179 DOI: 10.34172/aim.2020.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 02/11/2019] [Indexed: 11/09/2022]
Abstract
Collagenofibrotic glomerulopathy is a rare clinical entity with fewer than 40 cases reported worldwide. We describe a case of adult onset nephrotic syndrome with partial villous atrophy of the intestine who was diagnosed with this rare entity. Collagenofibrotic glomerulopathy is characterized by subendothelial and mesangial collagen type III deposition and increased procollagen III peptide levels. Extra renal involvement has been described in the form of hypertension, anemia and microangiopathic hemolytic anemia but villous atrophy has not been associated with this condition so far, possibly reflecting the paucity of literature. We describe this case and review the condition in this report.
Collapse
Affiliation(s)
- Rakesh Agarwal
- Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
| | - Rashmi Baid
- Lilavati Hospital & Research Centre, Mumbai, India
| | - Jotideb Mukhopadhyay
- Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
| |
Collapse
|
7
|
Jakopin E, Bevc S, Ekart R, Hojs R. Collagen type III nephropathy as a systemic disease? - A case report. Nefrologia 2019; 40:106-108. [PMID: 31377028 DOI: 10.1016/j.nefro.2019.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/24/2019] [Accepted: 04/15/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- Eva Jakopin
- University Medical Centre Maribor, Division of Internal Medicine, Department of Nephrology, Ljubljanska 5, Maribor, Slovenia.
| | - Sebastjan Bevc
- University Medical Centre Maribor, Division of Internal Medicine, Department of Nephrology, Ljubljanska 5, Maribor, Slovenia; University of Maribor, Faculty of Medicine, Taborska 5, Maribor, Slovenia
| | - Robert Ekart
- University Medical Centre Maribor, Division of Internal Medicine, Department of Dialysis, Ljubljanska 5, Maribor, Slovenia; University of Maribor, Faculty of Medicine, Taborska 5, Maribor, Slovenia
| | - Radovan Hojs
- University Medical Centre Maribor, Division of Internal Medicine, Department of Nephrology, Ljubljanska 5, Maribor, Slovenia; University of Maribor, Faculty of Medicine, Taborska 5, Maribor, Slovenia
| |
Collapse
|
8
|
Chen T, Achan A, Li K, Harris D. Collagenofibrotic Glomerulopathy. Nephrology (Carlton) 2018; 23:601-602. [PMID: 29890045 DOI: 10.1111/nep.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2017] [Indexed: 10/14/2022]
Affiliation(s)
- Titi Chen
- School of Medicine, The University of Sydney, Camperdown, New South Wales, Australia.,Centre for Transplant and Renal Research, The Westmead Institute for Medical Research, Westmead, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - Anita Achan
- Department of Anatomical Pathology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Kelly Li
- Department of Renal Medicine, St George Hospital, Kogarah, New South Wales, Australia
| | - David Harris
- School of Medicine, The University of Sydney, Camperdown, New South Wales, Australia.,Centre for Transplant and Renal Research, The Westmead Institute for Medical Research, Westmead, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| |
Collapse
|
9
|
Hara S, Tsukaguchi H, Oka T, Kusabe M, Mizui M, Joh K. Monoclonal immunoglobulin-associated proliferative glomerulonephritis characterized by organized deposits of striated ultra-substructures: A case report. Ultrastruct Pathol 2017. [PMID: 28628381 DOI: 10.1080/01913123.2017.1336189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We herein report the case of a 64-year-old male who presented with progressive glomerulonephritis notable for organized and striated ultra-substructures. The patient was diagnosed with hypertension and proteinuria 3 years prior to admission and subsequently developed nephrotic syndrome and impairment of renal function. Laboratory tests did not reveal any evidence of infections or autoimmune diseases. Monoclonal gammopathy was not detected in serum or urine, although a small population of abnormal plasma cell clones was detected by flow cytometry. A renal biopsy showed mesangial and endocapillary proliferative glomerulonephritis with lobular accentuation, accompanied with focal and segmental double-contour formation. Additionally, moderate tubulointerstitial scarring and arteriosclerosis were noted. Immunofluorescence staining revealed positive staining for IgG, IgM, C3, C1q, and fibrinogen. IgG subclass and light chain staining showed restricted positivity for IgG1κ. Electron microscopy demonstrated massive amounts of subendothelial deposits with a fibrillary and branching profile. At higher magnification, a periodic striated pattern was observed within the microfilament-like structures. Immunohistochemical staining was negative for myoglobin, laminin, and collagens (type III and IV). Steroid and antihypertensive therapy did not show improvement in renal function. The second biopsy performed 2 years later revealed a similar lobular proliferative glomerulonephritis pattern with more extensive tubulointerstitial damage, indicating poor response to immunosuppressive therapy. The patient progressed to end-stage renal disease and required hemodialysis. We discuss the possible origins of the deposits with unusual substructures observed in this case.
Collapse
Affiliation(s)
- Shigeo Hara
- a Department of Diagnostic Pathology , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Hiroyasu Tsukaguchi
- b 2nd Department of Internal Medicine , Kansai Medical University , Hirakata , Japan
| | - Tastufumi Oka
- c Department of Nephrology , Osaka University Graduate School of Medicine , Suita , Japan
| | - Makiko Kusabe
- b 2nd Department of Internal Medicine , Kansai Medical University , Hirakata , Japan
| | - Masayuki Mizui
- c Department of Nephrology , Osaka University Graduate School of Medicine , Suita , Japan
| | - Kensuke Joh
- d Department of Pathology , Tohoku University Graduate School of Medicine , Sendai , Japan
| |
Collapse
|
10
|
Yamamoto T, Togawa A, Eguchi M, Ohashi N, Yasuda H, Harita Y, Hattori M, Yamaguchi Y, Ohyama K. Glomerulopathy with distinctive fibrillar deposits but lacking glomerular deposition of type III collagen. CEN Case Rep 2017; 5:163-167. [PMID: 28508970 DOI: 10.1007/s13730-016-0217-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 02/21/2016] [Indexed: 11/27/2022] Open
Abstract
A 62-year-old woman with nephrotic syndrome underwent a renal biopsy. Under light microscopy, the biopsy findings included lobulation and enlargement of glomeruli, occasional thickening of glomerular capillary walls, and narrowing of the capillary lumen by swollen endothelial cells. Congo red staining was negative for amyloid. No significant intraglomerular fibrin deposition was found by phosphotungstic acid hematoxylin staining. Immunofluorescence microscopy showed no deposition of immunoglobulin G, A, or M; no κ or λ light chains; and no C3 or C1q. Electron microscopy revealed distinctive subendothelial and mesangial fibrillar deposits, mesangial cell interposition, and swelling and vacuolization of endothelial cells resulting in capillary lumen narrowing. Although some curvilinear fibrillar deposits mimicked the bundles of type III collagen fibers seen in collagenofibrotic glomerulopathy, neither glomerular deposition of type III collagen nor elevation of serum procollagen III peptide was noted. This glomerulopathy does not fulfill any known disease entities with non-amyloid non-immunoglobulin-derived organized glomerular deposits.
Collapse
Affiliation(s)
- Tatsuo Yamamoto
- Division of Nephrology, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan.
| | - Akashi Togawa
- Division of Nephrology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan
| | | | - Naro Ohashi
- First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideo Yasuda
- First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yutaka Harita
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motoshi Hattori
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Kunio Ohyama
- Division of Nephrology, Yokohama Daiichi Hospital, Yokohama, Japan
| |
Collapse
|
11
|
Nimmagadda S, Mukku K, Devaraju SR, Uppin MS. Unusual cause of glomerular deposition disease: Collagenofibrotic glomerulopathy. Indian J Nephrol 2017; 27:62-65. [PMID: 28182050 PMCID: PMC5255993 DOI: 10.4103/0971-4065.179300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Collagenofibrotic glomerulopathy is a rare condition characterized by deposition of Type III collagen fibers in the subendothelial space and mesangium of the glomerulus. Only 17 cases have been reported from India. A definite diagnosis can only be established when typical histological findings are supported by electron microscopy. It is characterized by indolent progression and has no definitive therapy.
Collapse
Affiliation(s)
- S Nimmagadda
- Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - K Mukku
- Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - S R Devaraju
- Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - M S Uppin
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| |
Collapse
|
12
|
Dong J, Wei H, Han M, Guan Y, Wu Y, Li H. Collagen type III glomerulopathy: A case report and review of 20 cases. Exp Ther Med 2015; 10:1445-1449. [PMID: 26622504 DOI: 10.3892/etm.2015.2695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 09/12/2014] [Indexed: 01/15/2023] Open
Abstract
Collagen type III glomerulopathy is a non-immune-mediated glomerular disease, characterized by abnormal accumulation of type III collagen fibrils within the mesangial matrix and subendothelial space. The clinical manifestations of this disease are proteinuria, peripheral edema, hypertension and occasional progression to end-stage renal disease. Collagen type III glomerulopathy is extremely rare, and its etiology and pathogenesis remain elusive. To date, only case reports are available and the majority of these are from Japan. To investigate the idiographic features of collagen type III glomerulopathy in China, we report a case of collagen type III glomerulopathy with two differing renal biopsies and review 20 cases in China. The majority of the Chinese patients were adults. Thirty percent of the patients had nephrotic syndrome, and hypertension was observed in 75% of cases. Elevated creatinine was present in 45% of patients. The pathology of collagen type III glomerulopathy in the Chinese cases was similar to that observed in other ethnicities, although certain cases were IgA-positive by immunofluorescence microscopy, and electron-dense material could be observed in the mesangial area. The onset age, clinical manifestations and pathological features of the disease are not exactly the same in China as worldwide.
Collapse
Affiliation(s)
- Junwu Dong
- Department of Nephrology and Rheumatology, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Honglan Wei
- Department of Nephrology and Rheumatology, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Min Han
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Yang Guan
- Department of Pathology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Yang Wu
- Department of Nephrology and Rheumatology, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Hua Li
- Department of Nephrology and Rheumatology, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| |
Collapse
|
13
|
Mohapatra A, Matthai SM, Vijayakumar K, Basu G. Quiz page: an unusual cause of nephrotic syndrome. Am J Kidney Dis 2015; 66:A18-21. [PMID: 26111909 DOI: 10.1053/j.ajkd.2014.12.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 12/19/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Anjali Mohapatra
- Nephrology Department, Christian Medical College, Vellore, India
| | - Smita Mary Matthai
- Central Electron Microscopy Unit, Christian Medical College, Vellore, India
| | | | - Gopal Basu
- Nephrology Department, Christian Medical College, Vellore, India.
| |
Collapse
|
14
|
Bao H, Chen H, Zhu X, Xu F, Zhu M, Zhang M, He Q, Zeng C, Liu Z. Clinical and morphological features of collagen type III glomerulopathy: a report of nine cases from a single institution. Histopathology 2015; 67:568-76. [PMID: 25753597 DOI: 10.1111/his.12685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Hao Bao
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| | - Huiping Chen
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| | - Xiaodong Zhu
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| | - Feng Xu
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| | - Maoyan Zhu
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| | - Minchao Zhang
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| | - Qian He
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| | - Caihong Zeng
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| | - Zhihong Liu
- National Clinical Research Center of Kidney Diseases; Jinling Hospital; Nanjing University School of Medicine; Nanjing China
| |
Collapse
|
15
|
Rørtveit R, Reiten MR, Lingaas F, Sveri SB, Brech A, Espenes A, Jansen JH. Glomerular Collagen V Codeposition and Hepatic Perisinusoidal Collagen III Accumulation in Canine Collagen Type III Glomerulopathy. Vet Pathol 2014; 52:1134-41. [DOI: 10.1177/0300985814560237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Collagen type III glomerulopathy, also known as collagenofibrotic glomerulopathy, is a rare renal disease of unknown pathogenesis. The disease occurs in humans and animals and is characterized by massive glomerular accumulations of collagen type III. In the present study, we describe a Drever dog litter affected by an early onset variant of this glomerular disease, where 4 of 9 puppies developed renal failure within 50 days of age. Necropsy specimens of kidney from the 4 affected cases were studied by light microscopy, electron microscopy, and immunohistochemistry, and characteristic lesions compatible with a diagnosis of collagen type III glomerulopathy were found. In addition, 2 cases showed atypical epithelium in the collecting ducts of the medulla, so-called adenomatoid change. Immunohistochemistry of renal specimens from collagen type III glomerulopathy-affected dogs ( n = 10) originating from two different dog strains, the Drever dogs and a mixed-breed strain, demonstrated that the deposited glomerular collagen is composed of a mixture of collagen III and collagen V. The distribution of the collagen V corresponded to the localization of collagen III; however, differences in staining intensity showed that collagen type III is the dominating component. Immunohistochemistry for collagen III ( n = 9) and a transmission electron microscopic study ( n = 1) showed hepatic perisinusoidal collagen type III deposition in affected cases from both dog strains. This is the first report documenting glomerular accumulations of collagen type V and perisinusoidal liver collagen III deposition in canine collagen type III glomerulopathy.
Collapse
Affiliation(s)
- R. Rørtveit
- Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo/Ås, Norway
| | - M. R. Reiten
- Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo/Ås, Norway
| | - F. Lingaas
- Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo/Ås, Norway
| | | | - A. Brech
- Centre for Cancer Biomedicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - A. Espenes
- Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo/Ås, Norway
| | - J. H. Jansen
- Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo/Ås, Norway
| |
Collapse
|
16
|
Aoki T, Hayashi K, Morinaga T, Tomida H, Hishida M, Yamamoto S, Kajiwara N, Tamai H. Two brothers with collagenofibrotic glomerulopathy. CEN Case Rep 2014; 4:85-89. [PMID: 28509277 DOI: 10.1007/s13730-014-0145-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 08/31/2014] [Indexed: 01/01/2023] Open
Abstract
Collagenofibrotic glomerulopathy is a rare glomerular disease characterized by extensive accumulation of atypical type III collagen fibers within the mesangial matrix and subendothelial space. Laboratory evaluation of this disease shows a marked increase in serum procollagen III peptide (P III P) levels. Here, we report the case of two brothers with collagenofibrotic glomerulopathy confirmed by histology. Patient 1 presented with proteinuria and hypertension and patient 2 presented with nephrotic-range proteinuria. Immunohistochemistry revealed strong staining for antibodies to type III collagen in the widened subendothelial spaces in both patients. Electron microscopy revealed numerous collagenous fibers in the mesangium and subendothelial space. P III P levels were elevated in both patients. Most reported cases of collagenofibrotic glomerulopathy, including the adult-onset type, have been sporadic. Within the limits of our literature search, this is only the third report of adult siblings with collagenofibrotic glomerulopathy confirmed by histology. This report indicates that it may be beneficial to measure serum P III P levels in the siblings of patients diagnosed with adult-onset collagenofibrotic glomerulopathy.
Collapse
Affiliation(s)
- Takafumi Aoki
- Department of Nephrology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo City, Aichi, 446-8602, Japan
| | - Kazuyuki Hayashi
- Department of Nephrology, Ikeda City Hospital, 3-1-18 Johnan, Ikeda, Osaka, 563-8510, Japan
| | - Takatoshi Morinaga
- Department of Nephrology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo City, Aichi, 446-8602, Japan.
| | - Hidetaka Tomida
- Department of Nephrology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo City, Aichi, 446-8602, Japan
| | - Manabu Hishida
- Department of Nephrology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo City, Aichi, 446-8602, Japan
| | - Satoko Yamamoto
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamada-Oka, Suita-City, Osaka, 565-0871, Japan
| | - Nobuyuki Kajiwara
- Department of Nephrology, Ikeda City Hospital, 3-1-18 Johnan, Ikeda, Osaka, 563-8510, Japan
| | - Hirofumi Tamai
- Department of Nephrology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo City, Aichi, 446-8602, Japan
| |
Collapse
|
17
|
Rørtveit R, Eggertsdóttir AV, Thomassen R, Lingaas F, Jansen JH. A clinical study of canine collagen type III glomerulopathy. BMC Vet Res 2013; 9:218. [PMID: 24156559 PMCID: PMC3826668 DOI: 10.1186/1746-6148-9-218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 10/04/2013] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Collagen type III glomerulopathy (Col3GP), also known as collagenofibrotic glomerulonephropathy, is a rare renal disease with unknown pathogenesis that occurs in animals and humans. We recently described a naturally occurring canine autosomal recessive model of Col3GP, and the aim of the present work was to study the clinical features of canine Col3GP and compare with the human phenotype. In humans two different clinical syndromes with different age at onset (child- or adulthood) have been observed. In children a more aggressive course with familial occurrence is described, characterized by progressively increasing proteinuria, nephrotic syndrome, hypertension and chronic renal failure. A markedly increased serum level of the aminoterminal propeptide of type III procollagen (PIIINP) is considered a useful marker for the disease. Since Col3GP and concurrent hypocomplementemia have been observed in humans, we also aimed to investigate if hypocomplementemia was present in Col3GP affected dogs. A litter consisting of seven puppies, four Col3GP affected and three healthy unaffected, was observed from the day of birth until the affected puppies developed a mild or moderate renal azotemia. RESULTS During the period of observation growth retardation, increasing blood pressure, progressive proteinuria, azotemia, hypoalbuminemia, hypercholesterolemia and increased serum PIIINP were observed in all the affected dogs. Hypocomplementemia was not detected. Affected dogs were euthanized between 109 and 144 days of age, and pathological examinations revealed ascites and massive glomerular accumulations of collagen type III, consistent with Col3GP. CONCLUSIONS Dogs with Col3GP develop juvenile chronic renal failure, preceded by nephrotic syndrome, elevated serum PIIINP and hypertension, thus have similar clinical features as the juvenile Col3GP in humans. Further studies of this naturally occurring canine phenotype may provide more information on the pathogenesis and genetics of Col3GP in both animals and humans.
Collapse
Affiliation(s)
- Runa Rørtveit
- Department of Basic Sciences and Aquatic Medicine, Norwegian School of Veterinary Science, Oslo, Norway.
| | | | | | | | | |
Collapse
|
18
|
Hebert LA, Parikh S, Prosek J, Nadasdy T, Rovin BH. Differential diagnosis of glomerular disease: a systematic and inclusive approach. Am J Nephrol 2013; 38:253-66. [PMID: 24052039 DOI: 10.1159/000354390] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 07/16/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Glomerular disease is a complex and evolving topic. In evaluating a specific case it is not unusual for the clinician to ask: 'Am I missing something? Should I biopsy? When? Should I treat first, then biopsy?' This work, which is both evidence and experience based, is intended to address each of these concerns and many other issues relevant to the differential diagnosis of glomerular disease. SUMMARY The central approach is the use of diagnostic algorithms that are based on quantitative measures routinely obtained early in the course of the diagnostic evaluation. The algorithms are designed to be easy to navigate, systematic, and inclusive. Also provided is a detailed and prioritized list of recommended diagnostic testing, and the rationale for each test. KEY MESSAGE This work is intended to facilitate accurate diagnosis in the individual patient presenting with evidence of glomerular disease.
Collapse
Affiliation(s)
- Lee A Hebert
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
| | | | | | | | | |
Collapse
|
19
|
Abstract
Renal biopsy was introduced in the 1950s. By 1980 the pathologic diagnostic criteria for the majority of medical kidney diseases known today, including pediatric diseases, were established using light, electron microscopy and immunohistochemistry. However, it has become clear that there are limitations in the morphologic evaluation, mainly because a given pattern of injury can be caused by different aetiologies and, conversely, a single aetiology may present with more than one histological pattern. An explosion in kidney disease research in the last 20-30 years has brought new knowledge from bench to bedside rapidly and resulted in new molecular and genetic tools that enhance the diagnostic and prognostic power of the renal biopsy. Genomic technologies such as polymerase chain reaction (PCR), in situ hybridization and oligonucleotide microarrays, collectively known as genomics, detect single or multiple genes underscoring the pathologic changes and revealing specific causes of injury that may require different treatment. The aims of this review are to (1) summarize current recommendations for diagnostic renal biopsies encompassing light microscopy, immunofluorescence or immunohistochemistry and electron microscopy; (2) address the limitations of morphology; (3) show current contributions of genomic technologies adjunct to the renal biopsy, and provide examples of how these may transform pathologic interpretation into molecular disease phenotypes.
Collapse
|
20
|
Raparia K, Usman I, Kanwar YS. Renal morphologic lesions reminiscent of diabetic nephropathy. Arch Pathol Lab Med 2013; 137:351-9. [PMID: 23451746 DOI: 10.5858/arpa.2012-0243-ra] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Nodular, intercapillary glomerulosclerotic lesions resembling Kimmelstiel-Wilson nodules commonly observed in diabetic nephropathy can also be seen in patients without any clinical history or evidence of diabetes. OBJECTIVES To discuss the pathobiology of lesions reminiscent of diabetes nephropathy, including light-chain deposition disease, amyloidosis, immunotactoid nephropathy, the membranoproliferative form of glomerulonephritis, and idiopathic nodular glomerulosclerosis, and how to differentiate them from diabetic nephropathy. DATA SOURCES Published literature and authors' personal experience. CONCLUSIONS The well-formed, intercapillary, nodular mesangial lesions, along with thickened glomerular basement membranes and tubular basement membranes, and hyaline arteriolosclerosis are virtually pathognomic of diabetic nephropathy. However, the pathologist must exclude lesions reminiscent of diabetic nephropathy by performing special stains on histologic sections, immunofluorescence, and electron microscopic studies.
Collapse
Affiliation(s)
- Kirtee Raparia
- Department of Pathology, Northwestern University Medical School, Chicago, IL 60611, USA
| | | | | |
Collapse
|
21
|
Rørtveit R, Lingaas F, Bønsdorff T, Eggertsdóttir AV, Grøndahl AM, Thomassen R, Fogo AB, Jansen JH. A canine autosomal recessive model of collagen type III glomerulopathy. J Transl Med 2012; 92:1483-91. [PMID: 22890554 DOI: 10.1038/labinvest.2012.112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Collagen type III glomerulopathy (Col3GP) is a rare renal disease characterized by massive glomerular accumulations of collagen type III. The disease occurs in both humans and animals, and has been presumed to be heritable with an autosomal recessive inheritance pattern. The pathogenesis is unknown. We describe herein a condition of canine autosomal recessive Col3GP. This spontaneously occurring canine disease was incidentally diagnosed in six mongrel dogs. We then established and studied a pedigree segregating the disease to confirm the genetic nature and inheritance of canine Col3GP. Twenty-nine percent of offspring (14/48) were affected, strongly supporting a simple autosomal recessive inheritance pattern. Kidney specimens were studied by light microscopy, electron microscopy (EM), immunohistochemistry and in situ hybridization. Characteristic findings of Col3GP previously reported in both humans and animals were demonstrated, including massive glomerular collagen type III deposition, and evidence of local mesangial collagen type III synthesis was found. We propose that canine Col3GP may serve as an animal model of human Col3GP. Our initial studies, using simple segregation analysis, showed that the Col3A1 gene was not involved in the disease. This is the first animal model of Col3GP, and further studies of this phenotype in dogs may have the potential to provide information on the pathogenesis and genetics of the disease in both animals and humans, and may thus contribute to the development of treatment regimes.
Collapse
Affiliation(s)
- Runa Rørtveit
- Department of Basic Sciences and Aquatic Medicine, Norwegian School of Veterinary Science, Oslo, Norway.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Cohen AH. Collagen Type III Glomerulopathies. Adv Chronic Kidney Dis 2012; 19:101-6. [PMID: 22449347 DOI: 10.1053/j.ackd.2012.02.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 02/23/2012] [Accepted: 02/23/2012] [Indexed: 01/15/2023]
Abstract
The 2 rare disorders characterized by the pathological accumulation of collagen type III in glomeruli are discussed. These are collagenofibrotic glomerulopathy, also known as collagen type III glomerulopathy, and the nail-patella syndrome. Although there are similarities in abnormal morphology, with type III collagen in mesangium and/or capillary walls, there is no genetic or pathogenic link to them. Collagenofibrotic glomerulopathy presents either in childhood, often with a family history suggesting autosomal recessive inheritance, or in adults as a sporadic occurrence. Proteinuria is the typical manifestation, with progression to ESRD in approximately 10 years. Although there is markedly elevated serum precursor collagen type III protein in the circulation, the usual manner of diagnosis is with kidney biopsy, which discloses type III collagen in subendothelial aspects of capillary walls and often in the mesangial matrix. Glomerular involvement in the nail-patella syndrome invariably presents in a patient with an established diagnosis of this multisystem disorder with orthopedic and cutaneous manifestations. It is owing to mutations in the gene LMX1B. Although the lesion may be asymptomatic, it is usually manifested by proteinuria. Structural lesions are of collagen type III within glomerular basement membranes, different in distribution to collagenofibrotic glomerulopathy. The clinical course is variable.
Collapse
|
23
|
Duggal R, Nada R, Rayat CS, Rane SU, Sakhuja V, Joshi K. Collagenofibrotic glomerulopathy-a review. Clin Kidney J 2012; 5:7-12. [PMID: 26069739 PMCID: PMC4400455 DOI: 10.1093/ndtplus/sfr144] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 09/07/2011] [Indexed: 12/12/2022] Open
Abstract
Collagenofibrotic glomerulopathy (CG) is a rare cause of idiopathic nephrotic syndrome characterized by massive accumulation of atypical Type III collagen fibrils within the mesangial matrix and subendothelial space of the glomeruli. A definite diagnosis can be established when typical histological findings are supported by electron microscopy. This disease exhibits indolent progression and as yet has no specific treatment. The present article reviews the clinicopathological features, epidemiology and proposed mechanisms of pathogenesis of CG. A search of the English language literature identified 38 cases of CG, of which 22 are reported from Asian countries. An additional three cases are being reported from this Institute in India and are illustrated herein. These reports contribute to a better understanding of this disease, which although not as prevalent, should be considered as a differential diagnosis in cases of mesangiocapillary form of glomerular injury.
Collapse
Affiliation(s)
- Rajan Duggal
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritambhra Nada
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Charan Singh Rayat
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Swapnil U Rane
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinay Sakhuja
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kusum Joshi
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
24
|
Schledzewski K, Géraud C, Arnold B, Wang S, Gröne HJ, Kempf T, Wollert KC, Straub BK, Schirmacher P, Demory A, Schönhaber H, Gratchev A, Dietz L, Thierse HJ, Kzhyshkowska J, Goerdt S. Deficiency of liver sinusoidal scavenger receptors stabilin-1 and -2 in mice causes glomerulofibrotic nephropathy via impaired hepatic clearance of noxious blood factors. J Clin Invest 2011; 121:703-14. [PMID: 21293057 DOI: 10.1172/jci44740] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 11/10/2010] [Indexed: 01/13/2023] Open
Abstract
Tissue homeostasis and remodeling are processes that involve high turnover of biological macromolecules. Many of the waste molecules that are by-products or degradation intermediates of biological macromolecule turnover enter the circulation and are subsequently cleared by liver sinusoidal endothelial cells (LSEC). Besides the mannose receptor, stabilin-1 and stabilin-2 are the major scavenger receptors expressed by LSEC. To more clearly elucidate the functions of stabilin-1 and -2, we have generated mice lacking stabilin-1, stabilin-2, or both stabilin-1 and -2 (Stab1–/– Stab2–/– mice). Mice lacking either stabilin-1 or stabilin-2 were phenotypically normal; however, Stab1–/– Stab2–/– mice exhibited premature mortality and developed severe glomerular fibrosis, while the liver showed only mild perisinusoidal fibrosis without dysfunction. Upon kidney transplantation into WT mice, progression of glomerular fibrosis was halted, indicating the presence of profibrotic factors in the circulation of Stab1–/– Stab2–/– mice. While plasma levels of known profibrotic cytokines were unaltered, clearance of the TGF-β family member growth differentiation factor 15 (GDF-15) was markedly impaired in Stab1–/– Stab2–/– mice but not in either Stab1–/– or Stab2–/– mice, indicating that it is a common ligand of both stabilin-1 and stabilin-2. These data lead us to conclude that stabilin-1 and -2 together guarantee proper hepatic clearance of potentially noxious agents in the blood and maintain tissue homeostasis not only in the liver but also distant organs.
Collapse
Affiliation(s)
- Kai Schledzewski
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Khubchandani SR, Chitale AR, Gowrishankar S. Banded collagen in the kidney with special reference to collagenofibrotic glomerulopathy. Ultrastruct Pathol 2010; 34:68-72. [PMID: 20192702 DOI: 10.3109/01913120903506611] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The normal glomerular basement membrane, composed of type IV collagen, plays an important function in the process of filtration. Rarely, type III, type I, or type V collagen is seen in the glomerulus, resulting in three different types of non-immune mediated glomerulopathies recognized thus far. These are characterized by deposition of banded collagen fibers in the glomerulus. METHODS The authors reviewed 4934 kidney biopsies submitted over the past 5 years. Five of these revealed the presence of banded collagen in the glomeruli. CONCLUSION Combined clinical and ultrastructural examination has led to a definitive diagnosis. These diseases exhibit indolent progression and as yet do not have specific treatment.
Collapse
|
26
|
Ohtani H, Wakui H, Komatsuda A, Goto H, Tada M, Ozawa M, Kobayashi R, Sawada KI. Progressive glomerulopathy with unusual deposits of striated structures: a new disease entity? Nephrol Dial Transplant 2010; 25:2016-9. [DOI: 10.1093/ndt/gfq037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
27
|
Ferreira RDR, Custódio FB, Guimarães CSO, Corrêa RRM, Reis MA. Collagenofibrotic glomerulopathy: three case reports in Brazil. Diagn Pathol 2009; 4:33. [PMID: 19781083 PMCID: PMC2761860 DOI: 10.1186/1746-1596-4-33] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Accepted: 09/25/2009] [Indexed: 01/15/2023] Open
Abstract
Background We are reporting the first Collagenofibrotic Glomerulopathy (CG) in South America. So, this collagen type III glomerulopathy is not limited to Japan but may be found throughout the world. Case Reports We describe three patients that presented some factors in common, such as sex, age and the presence of non-nephrotic proteinuria associated with microscopic hematuria. The findings with the immunofluorescence microscopy, of immunoglobulins, and components of the complement were usually negative. The picrosyrius staining showed the presence of reddish material in the mesangium, when it was seen under standard microscopy; however, when it was seen with birefringence, it became greenish under polarized light, showed the collagen found in this area of the glomerulus. The identification of CG was made through electronic microscopic scanning, and curved and disorganized fibers were found. Conclusion These cases are the first from South America to be reported, and they are about an idiopathic renal disease that is not related to any specific races or locations. The reports contribute to a better understanding of this disease, which although not so prevalent, should be considered as an importantly differential diagnostic of cases of proteinuria.
Collapse
Affiliation(s)
- Renata D R Ferreira
- Discipline of General Pathology, Biological Sciences Department, Triângulo Mineiro Federal University, Uberaba, Minas Gerais State, Brazil.
| | | | | | | | | |
Collapse
|
28
|
Kamiie J, Yasuno K, Ogihara K, Nakamura A, Tamahara S, Fujino Y, Ono K, Shirota K. Collagenofibrotic Glomerulonephropathy with Fibronectin Deposition in a Dog. Vet Pathol 2009; 46:688-92. [DOI: 10.1354/vp.08-vp-0272-s-cr] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
We report herein a case of collagenofibrotic glomerulonephropathy in a 3-year-old Shiba Inu with severe proteinuria. Histologically, renal glomeruli were enlarged with massive deposition of a homogeneous eosinophilic substance within the mesangium and capillary walls. The deposits reacted weakly with periodic acid-Schiff, stained deep blue with Masson's trichrome, and were positive by immunofluorescence for type III collagen and fibronectin. Ultrastructurally, the deposits consisted of fibrils and amorphous material in the mesangial matrix and beneath the glomerular capillary endothelium. The fibrils had transverse bands analogous to those of collagen fibrils. Electron microscopy also revealed focal detachment of podocytes and foot process effacement in glomerular tufts, which suggested that podocyte injury had contributed to the development of proteinuria in this dog. The current case resembles collagenofibrotic glomerulonephropathy (CFGN) in humans in histopathologic, immunofluorescence, and electron microscopic findings. This is the first report of CFGN in a nonhuman species with glomerular deposition of fibronectin and type III collagen.
Collapse
Affiliation(s)
- J. Kamiie
- Laboratory of Veterinary Pathology, Azabu University, Sagamihara, Kanagawa
| | - K. Yasuno
- Research Institute of Biosciences, Azabu University, Sagamihara, Kanagawa
| | - K. Ogihara
- Laboratory of Environmental Pathology, Azabu University, Sagamihara, Kanagawa
| | - A. Nakamura
- Laboratory of Veterinary Clinical Pathology, Graduate School of Agricultural and Life Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - S. Tamahara
- Laboratory of Veterinary Clinical Pathology, Graduate School of Agricultural and Life Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Y. Fujino
- Laboratory of Veterinary Clinical Pathology, Graduate School of Agricultural and Life Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - K. Ono
- Laboratory of Veterinary Clinical Pathology, Graduate School of Agricultural and Life Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - K. Shirota
- Laboratory of Veterinary Pathology, Azabu University, Sagamihara, Kanagawa
- Research Institute of Biosciences, Azabu University, Sagamihara, Kanagawa
| |
Collapse
|
29
|
Huerta A, Segovia B, Hernández A, Morales E, González J, Mérida E, Angel Martínez M, Praga M. When the finding of glomerular fibrils in patients with nephrotic syndrome leads to an erroneous diagnosis. NDT Plus 2009; 2:63-6. [PMID: 25949290 PMCID: PMC4421491 DOI: 10.1093/ndtplus/sfn167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Accepted: 10/08/2008] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ana Huerta
- Departments of Nephrology and Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Beatriz Segovia
- Departments of Nephrology and Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Aurelio Hernández
- Departments of Nephrology and Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Enrique Morales
- Departments of Nephrology and Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jorge González
- Departments of Nephrology and Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Eva Mérida
- Departments of Nephrology and Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Miguel Angel Martínez
- Departments of Nephrology and Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Manuel Praga
- Departments of Nephrology and Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| |
Collapse
|
30
|
KOBAYASHI R, YASUNO K, OGIHARA K, YAMAKI M, KAGAWA Y, KAMIIE J, SHIROTA K. Pathological Characterization of Collagenofibrotic Glomerulonephropathy in a Young Dog. J Vet Med Sci 2009; 71:1137-41. [DOI: 10.1292/jvms.71.1137] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Kinji SHIROTA
- Research Institute of Biosciences, Azabu University
- Laboratory of Veterinary Pathology, Azabu University
| |
Collapse
|
31
|
Roberts ISD, Gleadle JM. Familial nephropathy and multiple exostoses with exostosin-1 (EXT1) gene mutation. J Am Soc Nephrol 2008; 19:450-3. [PMID: 18216313 DOI: 10.1681/asn.2007080842] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Glomerular deposition of fibrillar collagen is a characteristic finding of genetically distinct conditions, including nail-patella syndrome and collagen type III glomerulopathy. A case of familial nephropathy in which steroid-sensitive nephrotic syndrome and glomerular deposits of fibrillar collagen are associated with multiple exostoses due to mutation of the EXT1 gene is described. This gene encodes a glycosyltransferase required for synthesis of heparan sulfate glycosaminoglycans. There is deficiency of heparan sulfate and perlecan, together with accumulation of collagens, in the matrix of EXT1-associated osteochondromas. Similar glomerular basement membrane abnormalities could offer an explanation for both the renal ultrastructural changes and steroid-sensitive nephrotic syndrome.
Collapse
Affiliation(s)
- Ian S D Roberts
- Department of Cellular Pathology, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, United Kingdom.
| | | |
Collapse
|
32
|
Chen N, Pan X, Xu Y, Wang Z, Shi H, Yan F, Dong X. Two Brothers in One Chinese Family With Collagen Type III Glomerulopathy. Am J Kidney Dis 2007; 50:1037-42. [DOI: 10.1053/j.ajkd.2007.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Accepted: 08/07/2007] [Indexed: 11/11/2022]
|