الفهرس 
Histology of the KidneyOnly 14 pages are availabe for public view
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Abstract
Background: Focal segmental glomerulosclerosis (FSGS) and Minimal change disease (MCD) are two disease entities presented mainly by nephrotic syndrome. While 95% of MCD cases showed complete remission on steroid therapy, 50% of FSGS cases progress to end stage renal disease. By microscopic examination FSGS is characterized by presence of sclerotic lesions which are absent in MCD, but these sclerotic lesions especially early ones may be missed in routine examination. Here we try to detect early small glomerular segmental sclerotic lesions through detection of activated parietal epithelial cells (PECs) on glomerular tuft by using claudin-1 immunohistochemical (IHC) staining.
Aim of the work: To differentiate early FSGS from MCD by detection of activated PECs in early glomerular sclerotic lesions using Claudin-1 IHC staining.
Patients and Methods: This retrospective study included 48 cases ; 28cases diagnosed as MCD and 20 cases diagnosed as early FSGS . Collected from Pathology lab and Electron Microscopy unit at Ain Shams University Specialized Hospital, Cairo during the period from 2011-2016. Clinicopathological data collection and claudin-1 IHC staining were performed in all cases and the results were statistically analyzed.
Results: A statistically significant correlation was detected between claudin-1 expression and the initial diagnosis of the studied groups (P=0.005) .Claudin-1 was expressed on (39.28%) of the biopsies initially diagnosed as MCD confirming that these cases are early FSGS lesions that were missed in the initial diagnosis, 63.64% of these positive cases were presented by steroid resistant nephrotic syndrome.
Conclusion: In view of current study we concluded the possible use of Claudin-1 as a novel diagnostic marker that can differentiate between confusing cases of early FSGS versus MCD especially in steroid resistant cases.