Glomerular epithelial cell phenotype in diffuse mesangial sclerosis: A report of 2 cases with markedly increased urinary podocyte excretion

Yohei Ikezumi, Toshiaki Suzuki, Tamaki Karasawa, Utako Kaneko, Takeshi Yamada, Hiroya Hasegawa, Michio Nagata, Akihiko Saitoh

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We report 2 cases of diffuse mesangial sclerosis (DMS) accompanied by severe podocyte excretion in urine. Patient 1 was a 9-day-old girl with a WT1 mutation who developed Wilms tumor at 6 months of age and was subsequently diagnosed with Denys-Drash syndrome. Patient 2 was a 1-year-old boy without a WT1 abnormality but presenting with heavy proteinuria. In both patients, histological examination showed findings of DMS. Immunohistochemical staining for synaptopodin (a podocyte marker) revealed a reduced number of podocytes in the glomeruli with severe sclerosis; however, podocytes persisted in the relatively intact glomeruli. Some glomeruli were accompanied by sclerotic lesions surrounded by proliferating cells; immunofluorescence staining revealed a majority of these proliferating cells to be positive for claudin-1 (a parietal cell marker) but negative for synaptopodin. These findings suggest that podocyte loss and the consequent proliferation of parietal cells are common processes in the pathogenesis of DMS.

Original languageEnglish
Pages (from-to)1778-1783
Number of pages6
JournalHuman Pathology
Issue number8
Publication statusPublished - 01-01-2014


All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

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