Light microscopy may show either no abnormality or minimal
increase in mesangial cellularity. Also, immunofluorescent
microscopy may show no immune deposits. Electron microscopy
may show fusion of foot processes of epithelial cells (podocytes).
Idiopathic type of this lesion usually clinically presents as steroid
sensitive nephrotic syndrome with good prognosis.
- Focal and segmental glomerulosclerosis (Figure 3.2):
The glomerular lesions under light microscopy are sclerotic. These
lesions involve only parts of the affected glomeruli (i.e. segmental)
and some glomeruli look normal, but in between a glomerulus is
affected (i.e. focal).
This disease usually presents with nephrotic syndrome with
impairement of kidney function and hypertension. Response to
steroid treatment is much less than that in minimal change
glomerulonephritis. - Membranous glomerulonephritis (Figure 3.3):
In this type of glomerulopathy, light microscopic examination
shows diffuse thickening of the glomerular capillary basement
membrane with no proliferation in the mesangium.
This disease usually presents as nephrotic syndrome with
spontaneous remissions and exacerbations. It may be steroid
sensitive.