Idiopathic nodular glomerulosclerosis in a non-diabetic hypertensive smoker--case report and review of literature

Abstract

Nodular glomerulosclerosis in diabetes mellitus (DM) has been a well-recognized occurrence since first described by Kimmelsteil and Wilson [1]. Other disease conditions in which nodular glomerulosclerosis has been observed include lobular variant of membranoproliferative glomerulonephritis [2,3], Takayasu’s arteritis [4], light chain glomerulopathy [5], immunotactoid glomerulopathy [6], amyloidosis and fibrillary glomerulopathy [7,8] and collagen type III disease [9]. But when nodular glomerulosclerosis occurs in the absence of any of these conditions, it is called idiopathic nodular glomerulosclerosis (ING) [10], a diagnosis of exclusion. We report a case of this rare condition in a patient who had a long history of hypertension, hypercholesterolaemia and smoking with persistent hyperamylasaemia. This review aims to analyse all reported cases of ING to try and delineate the nature of this entity in order that ING be included in the long list of causes of nephrotic syndrome.