NEPHROTIC SYNDROME IN MASSIVE OBESITY - STUDY BY LIGHT, IMMUNOFLUORESCENCE, AND ELECTRON-MICROSCOPY

Abstract

The morphologic features observed in the renal biopsy specimens from 3 patients with massive obesity complicated by the nephrotic syndrome were described. In the 2 patients with active disease, the majority of the glomeruli showed focal to extensive fibrin deposition within and adjacent to capillary loops, associated with adhesions to Bowman''s capsule, with a variable endocapillary proliferative response. In the patient with inactive disease, the majority of the glomeruli appeared normal. Fibrin-like material, similar to that seen in the active phase, was infrequently found ultrastructurally in the subendothelial portion of the capillary loops. Subendothelial vacuolated material was also observed. Although intravascular coagulation was suggested in this disorder, only minor coagulation abnormalities were discovered. In 2 of the patients the massive proteinuria resolved with weight reduction.