Abstract
We present a case of a 36-year-old female from Ghana who presented with atypical chest pain and shortness of breath and was found to have bilateral transudative pleural effusion and trivial pericardial effusion. Further work-up revealed serological markers consistent with active lupus and negative HIV. She developed rapid deterioration of her renal function requiring dialysis. Her renal biopsy showed collapsing focal segmental glomerulosclerosis with diffuse mesangial proliferative glomerulonephritis, consistent with lupus nephritis class II along with tubular degenerative changes. She was started on high dose steroids and later on mycophenolate mofetil. Her renal function slowly recovered to baseline.
Highlights
Collapsing glomerulopathy is segmental or global wrinkling and collapse of capillary walls and overlying epithelial cell proliferation [1]
An increasing number of cases are being reported as awareness among health care professionals is increasing [3]. It is a podocytopathy with distinct clinicopathologic features from focal segmental glomerulosclerosis as the lesions are characterized by formation of pseudocrescents and by collapse of capillary loops rather than extracellular matrix accumulation and glomerulosclerosis being a late manifestation
Collapsing glomerulosclerosis presents with proteinuria, resistant to most available treatments, and leads to rapid progression towards renal failure
Summary
Collapsing glomerulopathy is segmental or global wrinkling and collapse of capillary walls and overlying epithelial cell proliferation [1]. An increasing number of cases are being reported as awareness among health care professionals is increasing [3]. It is a podocytopathy with distinct clinicopathologic features from focal segmental glomerulosclerosis as the lesions are characterized by formation of pseudocrescents and by collapse of capillary loops rather than extracellular matrix accumulation and glomerulosclerosis being a late manifestation. Three variants have been described in the literature including idiopathic, genetic, and reactive [4]. We present a case of a patient with collapsing glomerulosclerosis which will provide more insight and further research opportunities in regard to the treatment of this distinct pathologic condition
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