NODULAR GLOMERULOSCLEROSIS OF UNKNOWN ORIGIN ASSOCIATED WITH THE NEPHROTIC SYNDROME

A 35-year-old male patient clinically characterized by massive protein uria and hypertension without evidence of systemic diseases is reporte d. Histological investigation of renal biopsy specimens revealed exten sive nodular formations in the mesangial areas in every glomerulus. Li ght-microscopic examination did not allow discrimination between the g lomerular changes found in these specimens and the nodular glomerulosc lerosis described in patients with diabetes mellitus. Electron-microsc opic examination confirmed the presence of massive, nodular, mesangial expansions consisting of finely fibrillar substances without electron -dense deposits and circumferential mesangial interposition. Immunoflu orescent examination showed the deposition of IgG, C3, fibrinogen and kappa and lambda light chains in mesangial areas, peripheral capillary loops and a part of the nodules. Furthermore, collagen types IV, V, V I and laminin were detected in the nodules. Amyloid was not observed i n these nodules. This diagnosis has not been made, and the mechanism o f this nodular glomerulosclerosis remains unknown.