Abstract
We present evidence of 2 distinct glomerular abnormalities in cyanotic congenital
heart disease—vascular and nonvascular—each believed to reflect a distinct pathogenesis.
Glomeruli from both kidneys were studied with light microscopy in 13 necropsied cyanotic
patients and in 8 controls. The vascular study characterized hilar arteriolar dilatation,
capillary diameter, glomerular diameter, and capillary engorgement with red blood
cells. The nonvascular study characterized juxtaglomerular cellularity, mesangeal
cellularity, mesangeal matrix, focal interstitial fibrosis, and megakaryocytic nuclei
per cm2 of renal cortex. There was a significant increase in each of the above vascular and
nonvascular items of interest relative to controls. Electron microscopy identified
whole megakaryocytes with their cytoplasm in glomeruli. The vascular abnormality is
believed to result from intraglomerular release of nitric oxide. The nonvascular abnormality
is believed to result from platelet-derived growth factor and transforming growth
factor- β.
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Article info
Publication history
Published online: August 16, 2004
Accepted:
June 9,
2000
Received in revised form:
June 9,
2000
Received:
April 5,
2000
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
