Abstract
Focal segmental glomerulosclerosis (FSGS) is a recognized cause of renal disease worldwide. The collapsing variant is distinct from the others, characterized clinically by a more severe nephrotic syndrome generally resistant to immunosuppressive therapy. It is known that a great number of patients progress to end-stage renal disease. Recognizing this lesion in biopsy is frequently challenging owing to the focal nature of the process which highlights the need for keeping a high index of suspicion for the diagnosis. We report and discuss a case of a non-HIV collapsing FSGS, followed by a complete (unexpected) renal recovery after an oral corticosteroid course.
Highlights
We report a case of a non-HIV collapsing Focal segmental glomerulosclerosis (FSGS), followed by complete renal recovery after an oral corticosteroid course
This case refers to an adult-onset collapsing FSGS, which was successfully treated after a corticosteroid course, maintaining total remission after a 19-month follow-up, without requiring additional immunosuppressant drugs
In summary, this case reports a rare subtype of FSGS called collapsing FSGS
Summary
Focal segmental glomerulosclerosis (FSGS) is marked by a characteristic histologic presentation that embraces segmental scarring involving some but not all glomeruli. Case Report A 74-year-old Caucasian woman was admitted to the hospital for periorbital and lower limb edema, orthopnea, anorexia and foamy urine for two weeks She mentioned an episode of respiratory tract infection one month before presenting, treated with a 3-day course of clarithromycin. Laboratory tests revealed mild anemia (hemoglobin 9.4 g/L), a serum creatinine of 2 mg/dL [baseline 0.85 mg/ dL], hypoalbuminemia (1.52 g/dL), hypercholesterolemia (total cholesterol 242 mg/dL, LDL 158 mg/dL) and moderate proteinuria (3.5 g/24-h), with no leukocytosis, thrombocytopenia or hematuria.
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