Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 142 No. 1718 (2012)

Outcome of fibrillary glomerulonephritis

  • Stefan Anton Kalbermatter
  • Claudio Marone
  • Donatella Casartelli
  • Martin Hausberg
  • Giovanni Banfi
  • Michael Mihatsch
  • Michael Dickenmann
DOI
https://doi.org/10.4414/smw.2012.13578
Cite this as:
Swiss Med Wkly. 2012;142:w13578
Published
22.04.2012

Summary

QUESTIONS UNDER STUDY: We assessed the long-term follow up of all the patients with fibrillary glomerulonephritis diagnosed since 1992 at our centre of reference for renal pathology in Basel.

METHODS: We performed a retrospective surveillance study with mail questionnaire based follow-up of all patients with the diagnosis of fibrillary glomerulonephritis found in the database of the department of renal pathology in Basel from 1992 to 2007. The outcome was assessed in terms of endstage renal disease (ESRD), death, reduction of proteinuria and improvement of estimated glomerular filtration rate (eGFR).

RESULTS: We obtained sufficient follow up data from 16 out of 20 identified patients. The mean follow up time was 35 months (1–115.1). Six patients died (37.5%), three without having ESRD. Six patients (37.5%) reached ESRD, five of them went on hemodialysis. Thirteen patients (81.3%) received an immunosuppressive therapy with steroids, five of them in combination with cyclophosphamide. The group without immunosuppressive therapy was too small to compare the two groups. In relation to the histological pattern membranous glomerulonephritis (MGN) had a better outcome as compared to the other histological patterns.

CONCLUSIONS: FGN is a heterogeneous disease associated with significant risk of ESRD and mortality. The histological type of the glomerulonephritis may influence the course of the disease.

References

  1. Rosenmann E, Eliakim M. Nephrotic syndrome associated with amyloid-like glomerular deposits. Nephron. 1977;18(5):301–8.
  2. Sturgill BC, Bolton WK, Griffith KM. Congo red-negative amyloidosis-like glomerulopathy. Human Pathology. 1985;16(3):220–4.
  3. Duffy JL, Khurana E, Susin M, Gomezleon G, Churg J. Fibrillary renal deposits and nephritis. Am J Pathol. 1983;113(3):279–90.
  4. Korbet SM, Schwartz MM, Rosenberg BF, Sibley RK, Lewis EJ. Immunotactoid glomerulopathy. Medicine. 1985;64(4):228–43.
  5. Alpers CE, Rennke HG, Hopper J, Biava CG. Fibrillary glomerulonephritis – an entity with unusual immunofluorescence features. Kidney Int. 1987;31(3):781–9.
  6. Churg J, Venkataseshan VS. Fibrillary glomerulonephritis without immunoglobulin deposits in the kidney. Kidney Int. 1993;44(4):837–42.
  7. Rosenstock JL, Markowitz GS, Valeri AM, Sacchi G, Appel GB, D’Agati VD. Fibrillary and immunotactoid glomerulonephritis: Distinct entities with different clinical and pathologic features. Kidney Int. 2003;63(4):1450–61.
  8. Iskandar SS, Falk RJ, Jennette JC. Clinical and pathological features of fibrillary glomerulonephritis. Kidney Int. 1992;42(6):1401–7.
  9. Fogo A, Qureshi N, Horn RG. Morphologic and clinical-features of fibrillary glomerulonephritis versus immunotactoid glomerulopathy. Am J Kidney Dis. 1993;22(3):367–77.
  10. Hvala A, Ferluga D, Vizjak A, Koselj-Kajtna M. Fibrillary noncongophilic renal and extrarenal deposits: A report on 10 cases. Ultrastructural Pathology. 2003;27(5):341–7.
  11. Fogo A, Qureshi N, Horn RG. Morphologic and clinical-features of fibrillary glomerulonephritis versus immunotactoid glomerulopathy. Am J Kidney Dis. 1993;22(5):757.
  12. Bridoux F, Hugue V, Coldefy O, Goujon JM, Bauwens M, Sechet A, et al. Fibrillary glomerulonephritis and immunotactoid (microtubular) glomerulopathy are associated with distinct immunologic features. Kidney Int. 2002;62(5):1764–75.
  13. Markowitz GS, Cheng JT, Colvin RB, Trebbin WM, D’Agati VD. Hepatitis c viral infection is associated with fibrillary glomerulonephritis and immunotactoid glomerulopathy. J Am Soc Nephrol. 1998;9(12):2244–52.
  14. Gielen GAL, Wetzels JFM, Steenbergen EJ, Muddle AH. Fibrillary glomerulonephritis in a patient with type 2 diabetes mellitus. Netherlands Journal of Medicine. 2006;64(4):119–23.
  15. Suzuki S, Konta T, Koizumi R, Nishida W, Abiko H, Kubota I. Fibrillary glomerulonephritis with hypocomplementemia. Internal Medicine. 2003;42(8):719–22.
  16. Haas M, Rajaraman S, Ahuja T, Kittaka M, Cavallo T. Fibrillary/immunotactoid glomerulonephritis in HIV-positive patients: a report of three cases. Nephrology Dialysis Transplantation. 2000;15(10):1679–83.
  17. Nasr SH, Valeri AM, Cornell LD, Fidler ME, Sethi S, Leung N, Fervenza FC. Fibrillary glomerulonephritis: A report of 66 cases from a single institution. Clin J Am Soc Nephrol. 2011;6(4):775–84.
  18. Dickenmann M, Schaub S, Nickeleit V, Mihatsch M, Steiger J, Brunner F. Fibrillary glomerulonephritis: Early diagnosis associated with steroid responsiveness. Am J Kidney Dis. 2002;40(3):E9.
  19. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. Modification Diet Renal Dis Study G. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Ann Intern Med. 1999;130(6):461‒70.
  20. Collins M, Navaneethan SD, Chung M, Sloand J, Goldman B, Appel G, Rovin BH. Rituximab treatment of fibrillary glomerulonephritis. Am J Kidney Dis. 2008;52(6):1158–62.

Most read articles by the same author(s)

1 2 > >>