Case Report

Clinical and Experimental Nephrology

, Volume 14, Issue 4, pp 385-388

First online:

Complete remission of non-HIV collapsing glomerulopathy with deflazacort and lisinopril in an adult patient

  • Jorge VegaAffiliated withDepartamento de Nefrología, Diálisis y Trasplante, Hospital Naval A. NefDepartamento de Medicina, Sección de Nefrología, Escuela de Medicina, Universidad de Valparaíso Email author 
  • , Francisco Javier GuardaAffiliated withEscuela de Medicina, Universidad Católica de Chile
  • , Helmuth GoeckeAffiliated withDepartamento de Nefrología, Diálisis y Trasplante, Hospital Naval A. NefDepartamento de Medicina, Sección de Nefrología, Escuela de Medicina, Universidad de Valparaíso
  • , Gonzalo P. MéndezAffiliated withDepartamento de Anatomía Patológica, Escuela de Medicina, Pontificia Universidad Católica de Chile

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Abstract

Collapsing glomerulopathy is a form of focal segmental glomerulosclerosis that is usually associated with HIV-1 infection, and is characterized by its poor prognosis and almost inevitable progression to end-stage renal disease. Its pathological features include collapsed glomeruli, podocyte hypertrophy and hyperplasia, and pseudocrescents. This case report shows the evolution of a 58-year-old patient with non-HIV idiopathic collapsing glomerulopathy who presented with severe nephrotic syndrome and renal insufficiency and was treated with lisinopril and deflazacort, a synthetic corticosteroid that has shown fewer cosmetic effects and glucose and bone metabolism complications than prednisone. The patient responded with full recovery of renal function and normal range of protein excreted in urine after less than two years of treatment. The patient has not suffered a recurrence of his nephrotic syndrome after three years of steroid withdrawal. There is no proven therapy for collapsing glomerulopathy, and this case highlights an alternative for treating this disease with few secondary effects.

Keywords

Collapsing glomerulopathy Nephrotic syndrome Deflazacort Lisinopril Focal segmental glomerulosclerosis Chronic kidney diseases Renal insufficiency