Idiopathic nodular glomerulosclerosis and differential diagnosis

ABSTRACT Introduction: Idiopathic nodular glomerulosclerosis (ING) is a condition that has a vasculopathic glomerular histological pattern. Case presentation: The authors present the case of a 44-year-old Hispanic smoker female with hypertension and peripheral arterial disease who presented nephrotic syndrome for 2 weeks. The patient was diagnosed with ING by percutaneous renal biopsy results, which showed global nodular mesangial matrix expansion, with linear staining accentuation of glomerular and tubular basement membrane for Immunoglobulin G (IgG) and albumin on immunofluorescence. Conclusions: ING is a rare disease with a poor renal prognosis and wide diagnostic approach; we highlight the importance of analyzing every piece of detail together to reach a definitive diagnosis.

摘要
引言：特发性结节性肾小球硬化症（Idiopathic nodular glomerulosclerosis, ING）是一类具有血管病变性肾小球组织学特征的疾病。
病例报告：本文报道1例44岁西班牙裔吸烟女性患者，该患者既往合并高血压与外周动脉疾病，因出现持续2周的肾病综合征就诊。经皮肾活检结果显示患者存在弥漫性结节性系膜基质扩张；免疫荧光检测可见肾小球及肾小管基底膜的免疫球蛋白G（Immunoglobulin G, IgG）与白蛋白呈线性染色增强，据此确诊为ING。
结论：ING是一种罕见疾病，肾脏预后较差且诊断思路宽泛；本文强调全面整合各项细节以明确最终诊断的重要性。