Abstract
From 44 patients with f.s.s.g. 75% suffered from a nephrotic syndrome, 25% from proteinuria, and 48% from erythrocyturia. The characteristic glomerular lesion is a progressive increase in mesangial matrix (sclerosis) which in early stages concerns only few glomeruli and within these only a portion of the capillary tuft. Histologically the remaining glomeruli show minimal changes, only. Electron microscopy, however, reveals these glomeruli as pathologically altered, too. PAS-positive hyaline deposits are identified with the light microscope in about 80% of all patients. Electron dense deposits, identical with immune deposits are regularly found within sclerosing areas, but rarely occur in minimally changed glomeruli, too. Immunofluorescence microscopy reveals a corresponding segmental deposition of IgM and C3. The findings suggest that the underlying mechanism is a diffuse one, but associated with focal accentuation which might depend on or be promoted by deposited immune aggregates.
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