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Adult Lipoid Nephrosis: Clinicopathological Correlations

[+] Article, Author, and Disclosure Information

Grant support: in part by USPHS grant 10980 and USPHS 00093 (RS). Dr. B. Spargo is the recipient of PHS Research Career Award K06-HL 4418.

Presented in part at the 6th Annual Meeting of the American Society of Nephrology, 19-20 November 1973, Washington, D.C.

▸Requests for reprints should be addressed to Victoria Sy Lim, M.D., Department of Medicine, Pritzker School of Medicine, The University of Chicago, 950 E. 59th St., Chicago, IL 60637.

Chicago, Illinois

Ann Intern Med. 1974;81(3):314-320. doi:10.7326/0003-4819-81-3-314
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Twenty-one patients with nephrotic syndrome and diffuse epithelial cell disease were studied retrospectively. They were arbitrarily divided into two groups; those with and without focal glomerulosclerosis. Among the 11 patients with minimal-change lesions, 3 had spontaneous complete remission, 6 had complete remission with therapy, and 2 died, one of septicemia and the other of cerebrovascular accident. All nine surviving patients sustained remissions after drug withdrawal, and their renal function remains excellent. Of the ten patients with focal glomerulosclerosis, none responded to treatment. Four of these 10 patients became moderately azotemic, and 2 progressed to renal failure. The presence of focal glomerulosclerosis in epithelial cell disease therefore warrants a guarded prognosis with respect to response to treatment and deterioration of renal function. Because the clinical manifestations of all patients were identical at the onset of illness, histologic study was the only criterion for classification and prognostication.





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