{Reference Type}: Case Reports
{Title}: Diabetic nephropathy with marked extra-capillary cell proliferation: a case report.
{Author}: Morimoto M;Namba-Hamano T;Notsu S;Iwata Y;Yasuhara Y;Yamato M;Isaka Y;
{Journal}: BMC Nephrol
{Volume}: 24
{Issue}: 1
{Year}: 2023 05 22
{Factor}: 2.585
{DOI}: 10.1186/s12882-023-03204-3
{Abstract}: Extra-capillary hypercellularity is a common finding in crescentic glomerulonephritis (GN) and focal segmental glomerulosclerosis (FSGS). In diabetic nephropathy (DN), extra-capillary hypercellularity is often observed as a finding of complications such as IgA nephropathy or microscopic polyangiitis superimposed on DN. However, in rare cases, epithelial cell proliferation may accompany DN. We experienced a case of nodular diabetic glomerulosclerosis with marked extra-capillary hypercellularity and revealed the origin of this atypical lesion using immunostainings.<BR>A man in his 50 s was admitted to the hospital with nephrotic syndrome, and a renal biopsy was performed. Diffuse nodular lesions and extra-capillary hypercellularity were observed, but the results of serological examination or immunofluorescent assays did not implicate any other crescentic GN. Immunostaining for claudin-1 and nephrin was performed to identify the origin of the extra-capillary lesions. Given the clinical course and pathological findings, a diagnosis of DN-associated extra-capillary cell proliferation was made.<BR>Extra-capillary hypercellularity, which resembles FSGS or crescentic GN, is a rare finding in DN and should therefore be treated with caution. In such cases, co-staining for claudin-1 and nephrin may facilitate the diagnosis of DN.