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Collapsing Glomerulopathy in a 16-Year-old Girl with Pulmonary Tuberculosis: The Role of Systemic Inflammatory Mediators

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Pediatric and Developmental Pathology

Abstract

Idiopathic collapsing glomerulopathy is an aggressive variant of focal segmental glomerulosclerosis (FSGS) seen primarily in adults. Its etiology is unknown. Nearly identical pathology is seen in association with nephrotic syndrome in human immunodeficiency virus type 1 (HIV-1)-infected patients, raising the possibility that viral infection plays a role in pathogenesis. This is supported by the recent discovery of parvovirus B19 DNA in some cases of idiopathic collapsing glomerulopathy. We report a case of collapsing glomerulopathy in a 16-year-old girl who presented with steroid-resistant nephrotic syndrome and pulmonary tuberculosis. In the absence of the usual associations (adult age group, African-American race, or history of intravenous drug abuse), infection is the sole known risk factor in this case. This lends support to the hypothesis that immune dysregulation due to infection per se, rather than infection by specific viral agents, may lead to collapsing glomerulopathy in susceptible individuals.

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References

  1. MA Weiss E Daquioag EG Margolin VE Pollak (1986) ArticleTitleNephrotic syndrome, progressive irreversible renal failure, and glomerular “collapse”: a new clinicopathologic entity Am J Kidney Dis 7 20–28 Occurrence Handle1:STN:280:DyaL287gtVCnug%3D%3D Occurrence Handle10.1016/S0272-6386(86)80052-X

    Article  CAS  Google Scholar 

  2. RK Detwiler RJ Falk SL Hogan JC Jennette (1994) ArticleTitleCollapsing glomerulopathy: a clinically and pathologically distinct variant of focal segmental glomerulosclerosis Kidney Int 45 1416–1424 Occurrence Handle1:STN:280:DyaK2czltF2qtw%3D%3D Occurrence Handle10.1038/ki.1994.185

    Article  CAS  Google Scholar 

  3. A Valeri L Barisoni GB Appel R Seigle V D’Agati (1996) ArticleTitleIdiopathic collapsing focal segmental glomerulosclerosis: a clinicopathologic study Kidney Int 50 1734–1746 Occurrence Handle1:STN:280:DyaK2s%2FntFWiuw%3D%3D Occurrence Handle10.1038/ki.1996.493

    Article  CAS  Google Scholar 

  4. A Laurinavicius S Hurwitz HG Rennke (1999) ArticleTitleCollapsing glomerulopathy in HIV and non-HIV patients: a clinicopathological and follow-up study Kidney Int 56 2203–2213 Occurrence Handle1:STN:280:DC%2BD3c%2FmtlWjug%3D%3D Occurrence Handle10.1046/j.1523-1755.1999.00769.x

    Article  CAS  Google Scholar 

  5. L Grcevska M Polenakovik (1999) ArticleTitleCollapsing glomerulopathy: clinical characteristics and follow-up Am J Kidney Dis 33 652–657 Occurrence Handle1:STN:280:DyaK1M3htFynsg%3D%3D Occurrence Handle10.1016/S0272-6386(99)70215-5

    Article  CAS  Google Scholar 

  6. MM Schwartz EJ Lewis (1985) ArticleTitleFocal segmental glomerular sclerosis: the cellular lesion Kidney Int 28 968–974 Occurrence Handle1:STN:280:DyaL287hs1ekuw%3D%3D Occurrence Handle10.1038/ki.1985.225

    Article  CAS  Google Scholar 

  7. AY Meyrier (1999) ArticleTitleCollapsing glomerulopathy: expanding interest in a shrinking tuft Am J Kidney Dis 33 801–803 Occurrence Handle1:STN:280:DyaK1M3htFyltg%3D%3D Occurrence Handle10.1016/S0272-6386(99)70239-8

    Article  CAS  Google Scholar 

  8. HK Singh LA Baldree DW McKenney SL Hogan JC Jennette (2000) ArticleTitleIdiopathic collapsing glomerulopathy in children Pediatr Nephrol 14 132–137 Occurrence Handle1:STN:280:DC%2BD3c7kvVCjtA%3D%3D Occurrence Handle10.1007/s004670050028

    Article  CAS  Google Scholar 

  9. S Meehan M Pascual WW Williams et al. (1998) ArticleTitleDe novo collapsing glomerulopathy in renal allografts Transplantation 65 1192–1197 Occurrence Handle1:STN:280:DyaK1c3msVejtA%3D%3D Occurrence Handle10.1097/00007890-199805150-00009

    Article  CAS  Google Scholar 

  10. T Nadasdy C Allen MS Zand (2002) ArticleTitleZonal distribution of glomerular collapse in renal allografts: possible role of vascular changes Hum Pathol 33 437–441 Occurrence Handle10.1053/hupa.2002.124333

    Article  Google Scholar 

  11. MB Stokes CL Davis CE Alpers (1999) ArticleTitleCollapsing glomerulopathy in renal allografts: a morphological pattern with diverse clinicopathologic associations Am J Kidney Dis 33 658–666 Occurrence Handle1:STN:280:DyaK1M3htFynsw%3D%3D Occurrence Handle10.1016/S0272-6386(99)70216-7

    Article  CAS  Google Scholar 

  12. GS Markowitz GB Appel PL Fine et al. (2001) ArticleTitleCollapsing focal segmental glomerulosclerosis following treatment with high dose pamidronate J Am Soc Nephrol 12 1164–1172 Occurrence Handle1:CAS:528:DC%2BD3MXktlyjsLg%3D Occurrence Handle11373339

    CAS  PubMed  Google Scholar 

  13. V Leblond H Beaufils C Ginsburg et al. (1994) ArticleTitleCollapsing focal segmental glomerulosclerosis associated with visceral leishmaniasis Nephrol Dial Transplant 9 1353 Occurrence Handle1:STN:280:DyaK2M7hsF2rsQ%3D%3D Occurrence Handle7816308

    CAS  PubMed  Google Scholar 

  14. NM Pakasa NM Nseka LM Nyimi (1997) ArticleTitleSecondary collapsing glomerulopathy associated with Loa loa filariasis Am J Kidney Dis 30 836–839 Occurrence Handle1:STN:280:DyaK1c%2FlvVyktQ%3D%3D Occurrence Handle10.1016/S0272-6386(97)90090-1

    Article  CAS  Google Scholar 

  15. A Moudgil CC Nast A Bagga et al. (2001) ArticleTitleAssociation of parvovirus B19 infection with idiopathic collapsing glomerulopathy Kidney Int 59 2126–2133 Occurrence Handle1:STN:280:DC%2BD3M3psF2qtw%3D%3D Occurrence Handle10.1046/j.1523-1755.2001.00727.x

    Article  CAS  Google Scholar 

  16. L Barisoni W Kriz P Mundel V D’Agati (1999) ArticleTitleThe dysregulated podocyte phenotype: a novel concept in the pathogenesis of collapsing idiopathic focal segmental glomerulosclerosis and HIV-associated nephropathy J Am Soc Nephrol 10 51–61 Occurrence Handle1:STN:280:DyaK1M7gsFeitw%3D%3D Occurrence Handle9890309

    CAS  PubMed  Google Scholar 

  17. I Kihara E Yaoita K Kawasaki T Yamamoto M Hara T Yanagihara (1999) ArticleTitleOrigin of hyperplastic epithelial cells in idiopathic collapsing glomerulopathy Histopathology 34 537–547 Occurrence Handle1:STN:280:DyaK1Mzhs1aluw%3D%3D Occurrence Handle10.1111/j.1365-2559.1999.00670.x

    Article  CAS  Google Scholar 

  18. S Tanawattanacharoen RJ Falk JC Jennette JB Kopp (2000) ArticleTitleParvovirus B19 DNA in kidney tissue of patients with focal segmental glomerulosclerosis Am J Kidney Dis 35 1166–1174 Occurrence Handle1:STN:280:DC%2BD3czgsFemtw%3D%3D Occurrence Handle10.1016/S0272-6386(00)70055-2

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, Kosair Children’s Hospital, 231 E. Chestnut Street, Louisville, KY, 40202, USA

    Susan Coventry & Lawrence R. Shoemaker

  2. Department of Pediatrics, University of Louisville School of Medicine, 571 S. Floyd Street, Suite 300, Louisville, KY, 40202, USA

    Susan Coventry

Authors
  1. Susan Coventry
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  2. Lawrence R. Shoemaker
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Correspondence to Susan Coventry.

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Coventry, S., Shoemaker, L. Collapsing Glomerulopathy in a 16-Year-old Girl with Pulmonary Tuberculosis: The Role of Systemic Inflammatory Mediators. Pediatr. Dev. Pathol. 7, 166–170 (2004). https://doi.org/10.1007/s10024-003-3027-4

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  • DOI: https://doi.org/10.1007/s10024-003-3027-4

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