A recent article referenced below in Kidney International Sept
2011 issue reveals a novel glomerular disease associated with
myeloproliferative neoplasms( CML, polycythemia vera, essential thrombocytosis,
mastocytosis, primary myelofibrosis and other) that usually become AML.
A description of 11 cases showed following characteristics:
1. mesangial scloerosis
2. hypecellularity
3. Segmental sclerosis
4. Chronic TMA findings
5. Intracapillary hematopoietic cell infiltration
6. No signs of immune complex mediated process by EM and IF
The term MPN related glomerulopathy is suggested. This is
interesting to note as clinically I have always wondered about the nephrotic
syndrome that is associated with these cases of MPN. In the literature, there
is information about the MPGN pattern of injury seen with such cases and
perhaps this is just semantics but looking at the findings suggests a
thrombotic microangiopathy and MPGN pattern of injury with novel findings
mainly of the cell infiltration( which might have been there in prior cases
published but not looked for ).
Morphologically, have to be differentiate from diabetic glomerular
changes, FSGS, TMA, and immune complex MPGN
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