The diagnosis of FSGS

The diagnosis clinically and there is no reliable indicators should rely on renal biopsy in the diagnosis of FSGS and pay attention to rule out all possible secondary factors, such as HIV infection, drugs such as focal segmental glomerulosclerosis check

. Asked in detail about the history, physical examination and laboratory tests are helpful in differential diagnosis. For example, the performance associated with proximal renal tubular dysfunction in patients with nephrotic syndrome, or simple proteinuria; persistent nephrotic syndrome with hypertension, microscopic hematuria, non-selective proteinuria; hormone-sensitive patients should be suspected of FSGS. Renal biopsy examination can help diagnose typical focal segmental glomerulosclerosis (FSGS) characteristics for focal damage, the local impact of a small number of glomerular (focal) and glomerular (segmental). Start at nearly the medulla of the glomerular involvement, mild cases involving only a few capillary loop, re-spread to most of the glomerular lesions were uniform without cells or minimal hyalinization substance (within the loop foam cells, transparent drops), and severe cases, the balloon adhesions, visceral epithelial cell proliferation to form a "cap-like" structure, or even the "umbilical" lesions. Another focal glomerulosclerosis. The involvement of tubular epithelial cells of the nephron often shrinking, the surrounding matrix, see cell infiltration, fibrosis. Electron microscope, most of the glomerular or glomerular foot process effacement, epithelial cells and their foot processes and basement membrane from the endothelial cells and mesangial electron dense deposits at. Immunofluorescence in the hardened area to see IgM and C3 were irregular lumps, nodular deposition. Glomerular lesions were negative or diffuse IgM, C3 deposition, IgA, IgG rare. The disease often misdiagnosed as minimal change nephropathy, and it requires a combination of clinical manifestations and renal histological findings and response to hormone therapy and presence of spontaneous remission or drug induced remission in fully taken into account. Help in the differential diagnosis of FSGS and MCD. Glomerular focal segmental sclerosis seen in FSGS can also be found in the development of a variety of chronic kidney disease, such as obstructive nephropathy, reflux nephropathy, AIDS patients and diamorphine addicts; can even be found in obese persons. Therefore, a comprehensive analysis to make the right diagnosis.Patients story how I beat FSGS