Adult Lipoid Nephrosis: Clinicopathological Correlations

Twenty-one patients with nephrotic syndrome and diffuse epithelial cell disease were studied retrospectively. They were arbitrarily divided into two groups; those with and without focal glomerulosclerosis. Among the 11 patients with minimal-change lesions, 3 had spontaneous complete remission, 6 had complete remission with therapy, and 2 died, one of septicemia and the other of cerebrovascular accident. All nine surviving patients sustained remissions after drug withdrawal, and their renal function remains excellent. Of the ten patients with focal glomerulosclerosis, none responded to treatment. Four of these 10 patients became moderately azotemic, and 2 progressed to renal failure. The presence of focal glomerulosclerosis in epithelial cell disease therefore warrants a guarded prognosis with respect to response to treatment and deterioration of renal function. Because the clinical manifestations of all patients were identical at the onset of illness, histologic study was the only criterion for classification and prognostication.