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Journal of the Korean Society of Pediatric Nephrology 2013;17(1): 13-18. doi: https://doi.org/10.3339/jkspn.2013.17.1.13
초점분절사구체경화증에서 발세포병증과 형태 변화
정현주
연세대학교 의과대학 병리학교실
Podocytopathy and Morphologic Changes in Focal Segmental Glomerulosclerosis
Hyeon Joo Jeong
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
Corresponding Author: Hyeon Joo Jeong ,Tel: 02-2228-1766, Fax: 02-362-0860, Email: jeong10@yuhs.ac
Received: November 25, 2012;  Accepted: December 13, 2012.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons. org/licenses/bync/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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ABSTRACT
Podocytopathy is glomerular lesions characterized by podocyte injury. It is observed in various glomerular diseases, but minimal change disease and focal segmental glomerulosclerosis (FSGS) are the prototypes. In this review, morphologic features of podocyte injury and subtypes of FSGS will be reviewed briefly. Effacement of podocyte foot processes is the most common feature of podocyte injury. As podocytic injury progresses, intracytoplasmic vacuoles, subpodocytic cyst, detachment of podocytes from the glomerular basement membrane and apoptosis develop. Glomerular capillary loops in epithelium-denuded area undergo capillary collapse. Synechia and hyalinosis may accompany this lesion. To manifest segmental sclerosis, podocyte loss above a threshold level may be required. Injured podocytes can injure neighboring intact podocytes, and thereby spread injury within the same lobule. FSGS can be categorized into five subtypes by morphologic characteristics; not otherwise specified (NOS), perihilar, cellular, tip, and collapsing types. Each subtype has been reported to show different clinical courses and associated conditions, but there are controversies on its significance. With recent progress in the discovery of genetic abnormalities causing FSGS and plasma permeability factors, we expect to unravel pathophysiology of FSGS and to understand histological sequences leading to FSGS in near future.
Key words: Focal segmental glomerulosclerosis | Morphology | Subtypes
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