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Renal pathology in nephrotic syndrome associated with genetic and systemic disorders (secondary nephrotic syndrome)

Renal pathology in nephrotic syndrome associated with genetic and systemic disorders (secondary nephrotic syndrome)
Podocytopathies: Minimal change or FSGS pattern
Infections: HIV, macrophage activation syndrome, polyomavirus, cytomegalovirus
Drugs: Interferon, pamidronate, NSAIDs, lithium, vaccines, venoms, stings
Malignancies: Thymoma, Hodgkin lymphoma (formerly called Hodgkin disease)
Genetic disorders of podocyte proteins (eg, nephrin, podocin, Alport syndrome, etc.)
Other: Sickle cell, myelodysplastic syndromes, hepatitis C, von Gierke disease, Fabry disease, dysautonomia, obesity
Membranous nephropathy pattern
Autoimmune disease: Lupus
Infections: Hepatitis B, malaria, syphilis
Malignancies: Solid organ tumors, leukemia
Drugs: Gold, mercury, heavy metals, captopril, penicillamine, NSAIDs
Other: Sarcoidosis, Sjögren's syndrome, graft-versus-host disease
Membranoproliferative pattern*
Autoimmune disease: Connective tissue diseases including lupus
Infection: Chronic bacterial infections (eg, endocarditis, VA shunts), hepatitis C
Chronic thrombotic microangiopathy
Malignancy: Monoclonal gammopathy, cryoglobulinemia
Other: POEMS syndrome
Transplant glomerulopathy
Glomerular deposition diseases
Amyloidosis: AL, AA, hereditary amyloidosis, and others
Other monoclonal deposition diseases*: Immunoglobulin deposition disease, immunotactoid glomerulopathy
Hereditary disorders
Alport syndrome*
Fabry disease*
Nail-patella syndrome
Partial lipodystrophy*
APOL1-associated nephropathy
Other
Diabetes mellitus
Idiopathic nodular glomerulosclerosis
Fibrillary glomerulonephritis*
Pregnancy related (includes preeclampsia)
FSGS: focal segmental glomerulosclerosis; HIV: human immunodeficiency virus; NSAIDs: nonsteroidal antiinflammatory drugs; VA: ventriculoatrial; POEMS: Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, Skin changes; APOL1: apolipoprotein L1; RBC: red blood cell.
* Indicates those disorders that could also present as a nephritic-nephrotic syndrome (RBC, RBC casts with nephrotic-range proteinuria).
Courtesy of Jai Radhakrishnan, MD, MS.
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