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Severe intraglomerular detachment of podocytes in a Gitelman syndrome patient.

Authors :
Takahashi, Naoki
Kimura, Hideki
Mizuno, Shinichi
Hara, Masanori
Hirayama, Yoshiaki
Kurosawa, Hiroyuki
Tsutaya, Shouji
Yasujima, Minoru
Yokoi, Seiji
Mikami, Daisuke
Kasuno, Kenji
Naiki, Hironobu
Iwano, Masayuki
Yoshida, Haruyoshi
Source :
Clinical & Experimental Nephrology. Jun2012, Vol. 16 Issue 3, p495-500. 6p.
Publication Year :
2012

Abstract

We report the case of a 38-year-old woman diagnosed with Gitelman syndrome. A kidney biopsy showed abundant floating cells in the Bowman's space of the mildly cystic glomeruli, moderate tubulointerstitial changes and apparent intimal thickening of small arteries. These floating cells were immunohistologically identified as podocytes, by the expression of podocalyxin, vimentin, Wilms' tumor 1, synaptopodin and nephrin with positivities of 100 %, 88.4 %, 80.4 %, 74.7 % and 22.6 %, respectively. In these phenotypes, nephrin expression was notably decreased in both detached and capillary-attached podocytes in comparison with normal control podocytes. Immunostaining of both detached and capillary-attached podocytes for Bax, Bcl-2, desmin, fibroblast-specific protein-1, α-smooth muscle actin and Ki-67 was negative, as were TUNEL assays. These results suggest that apoptosis and epithelial−mesenchymal transition were not the main cause of podocyte detachment in this patient. In addition, levels of urinary podocalyxin were not elevated, suggesting the detached podocytes were not excreted in the urine. To the best of our knowledge, this is the first report of severe intraglomerular non-apoptotic detachment of podocytes in Gitelman syndrome. This podocyte detachment may be associated with nephron obstruction and reduced nephrin expression. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13421751
Volume :
16
Issue :
3
Database :
Academic Search Index
Journal :
Clinical & Experimental Nephrology
Publication Type :
Academic Journal
Accession number :
76606835
Full Text :
https://doi.org/10.1007/s10157-012-0624-4