Abstract
We report a 7-year-old girl with IgA nephropathy presented with FSGS-like podocyte hypertrophy. She had microhematuria and nephrotic-range proteinuria. The initial renal biopsy specimens showed diffuse mesangial proliferation, endocapillary proliferation, double contours of capillary walls, fibrocellular crescent formation, and podocyte hypertrophy resembling FSGS.
Immunofluorescence studies demonstrated a predominant deposition of IgA along capillary walls. On electron microscopy, the deposits in the paramesangial and subendothelial areas were found. She was diagnosed as IgA nephropathy and treated with intravenous methylprednisolone pulse therapy. Thereafter the combined therapy of prednisolone, mizoribine, warfarin and dipyridamole was started. Proteinuria was reduced and serum total protein increased gradually. We performed the second biopsy of the kidney 6 months after initiation of the therapy. The second biopsy showed a moderate improvement of FSGS-like podocyte hypertrophy.
