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Additionally, a positive family history, heroin abuse, chronic viral infections, and use of associated medications must be ruled out during history-taking.
Additionally, a positive family history, heroin abuse, chronic viral infections, and use of associated medications must be ruled out during history-taking.
In contrast, patients with secondary FSGS is often present with non-nephrotic range proteinuria, serum albumin levels that are usually normal, and most importantly, there is no peripheral edema, even when protein excretion exceeds 3 to 4 g/day.<ref name="pmid19578004">{{cite journal| author=Fernandez-Fresnedo G, Segarra A, González E, Alexandru S, Delgado R, Ramos N et al.| title=Rituximab treatment of adult patients with steroid-resistant focal segmental glomerulosclerosis. | journal=Clin J Am Soc Nephrol | year= 2009 | volume= 4 | issue= 8 | pages= 1317-23 | pmid=19578004 | doi=10.2215/CJN.00570109 | pmc=2723972 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19578004  }} </ref>


==References==
==References==

Revision as of 18:44, 20 October 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Clinical Presentation

Generally, primary (idiopathic) focal segmental glomerulosclerosis (FSGS) starts abruptly whereas secondary FSGS has a more insidious onset. The hallmark of FSGS is nephrotic-range proteinuria, appearing in approximately 70% of patients.[1][2]

Common signs and symptoms associated with FSGS are shown below[1][2]:

  • Frothy/foamy urine suggestive of proteinuria
  • Red discoloration of urine suggestive of hematuria may be present
  • Headache and blurry vision, suggestive of high blood pressure
  • Signs of fluid overload, such as peripheral edema or periorbital edema
  • Dyspnea suggestive of pleural or pericardial effusion
  • Abdominal fullness suggestive of ascites
  • Fatigue and malaise
  • Other signs of renal insufficiency

Additionally, a positive family history, heroin abuse, chronic viral infections, and use of associated medications must be ruled out during history-taking.

In contrast, patients with secondary FSGS is often present with non-nephrotic range proteinuria, serum albumin levels that are usually normal, and most importantly, there is no peripheral edema, even when protein excretion exceeds 3 to 4 g/day.[3]


References

  1. 1.0 1.1 Rydel JJ, Korbet SM, Borok RZ, Schwartz MM (1995). "Focal segmental glomerular sclerosis in adults: presentation, course, and response to treatment". Am J Kidney Dis. 25 (4): 534–42. PMID 7702047.
  2. 2.0 2.1 Chun MJ, Korbet SM, Schwartz MM, Lewis EJ (2004). "Focal segmental glomerulosclerosis in nephrotic adults: presentation, prognosis, and response to therapy of the histologic variants". J Am Soc Nephrol. 15 (8): 2169–77. doi:10.1097/01.ASN.0000135051.62500.97. PMID 15284302.
  3. Fernandez-Fresnedo G, Segarra A, González E, Alexandru S, Delgado R, Ramos N; et al. (2009). "Rituximab treatment of adult patients with steroid-resistant focal segmental glomerulosclerosis". Clin J Am Soc Nephrol. 4 (8): 1317–23. doi:10.2215/CJN.00570109. PMC 2723972. PMID 19578004.

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