PMC5505910_01
Renal ultrasonography findings. Both kidneys are small but normally shaped.
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Ultrasonography showed that her kidneys were small, namely the right kidney being 8.7 cm long and the left one being 7.5 cm long, with an almost normal appearance (Fig. 1).
The renal biopsy findings are consistent with post-adaptive focal segmental glomerulosclerosis (FSGS). (a) The length of the renal cortex appears to be short (periodic acid-Schiff stain, Scale bar=1 mm). (b) The glomeruli are moderately enlarged (periodic acid-methenamine-silver stain, Scale bar=100 mum). (c) The glomerulus shows perihilar FSGS (periodic acid-methenamine-silver stain, Scale bar=100 mum). (d) Electron microscopy shows the relatively-preserved podocyte foot processes. Electron-dense deposits and endothelial cell swelling are not present (original magnification, x 5,750).
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Two biopsy specimens of the corticomedullary tissue, including the renal capsule, were obtained (Fig. 2a). Most glomeruli were enlarged (Fig. 2b), and the largest glomerulus reached a diameter of 308 microm. One glomerulus showed perihilar segmental sclerosis with adhesion to the Bowman's capsule (Fig. 2c). Immunofluorescence studies were all negative, and electron microscopy showed mild segmental foot process effacement (Fig. 2d).