CUNHA, Catia et al. Idiopathic nodular glomerulosclerosis: a case report. []. , 29, 4, pp.345-350. ISSN 0872-0169.

The histological pattern of nodular glomerulosclerosis is typical of diabetic nephropathy, but it can be found in other diseases, such as chronic membranoproliferative glomerulonephritis, amyloidosis, monoclonal immunoglobulin deposition and fibrillary/immunotactoid glomerulopathies. Additionally, there are few reports of idiopathic nodular glomerulosclerosis, an exclusion diagnosis, which has been associated with smoking. Herein we present a case of a non-diabetic 45-year-old man, with a background history of hypertension known for 5 years and heavy smoking, who was referred to our Nephrology clinic for evaluation of haematoproteinuria. Renal function was normal and serologies and immunoelectrophoresis studies were negative. Renal biopsy revealed a nodular glomerulosclerosis pattern on light microscopy, and immunofluorescence and electronic microscopy excluded other previously referred causes for this pattern. By exclusion, a diagnosis of idiopathicnodular glomerulosclerosis was established, probably in association with smoking and hypertension. Idiopathic nodular glomerulosclerosis is a distinct clinicopathologic entity that should be considered in patients with active smoking, especially if there is concomitant hypertension. Some authors actually suggest the designation of “smoking -related nodular glomerulosclerosis” to this “pseudodiabetic” glomerulopathy.

: Hypertension; nodular glomerulosclerosis; smoking.

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