MYELOPROLIFERATIVE DISORDER ASSOCIATED WITH FOCAL SEGMENTAL GLOMERULOSCLEROSIS: A CASE REPORT

Abstract

We report a rare case of focal segmental glomerulosclerosis (FSGS) with Myelofibrosis. A 57-year-old man with underlying Idiopathic Membranous Nephropathy (IMN) presented to us with chief complaints of frothy urine and leg swelling. Urine quantification showed nephrotic-range proteinuria. The patient underwent renal biopsy due to rapidly declining renal function and persistent proteinuria, in which the electron microscopy (EM) revealed the diagnosis of focal segmental glomerulosclerosis (FSGS) although initial light microscopy showed thickening of capillary loops which suggested MN. He was started on immunosuppressive therapy which consisted of calcineurin inhibitor and steroids, and his renal function and proteinuria improved. We wish to highlight the importance of incorporating EM as part of the routine histopathological assessment to yield a precise diagnosis.

Keywords: Focal Segmental Glomerulosclerosis, Membranous Nephropathy, Myelofibrosis, Nephrotic syndrome, Electron Microscopy