A Case of Collapsing Glomerulopathy in Renal Allograft

Korean Journal of Nephrology 2008;27(1):162-165.

Ji Hwan Kim, M.D.1, Jung IM Jung, M.D.1, Ju Yeon Nam, M.D.1 , Jong In Kim, M.D.1 Joong Kyung Kim, M.D.1, Yeon Soon Jung, M.D.2, Hark Rim, M.D.2 and Min Jung Jung, M.D.3

University College of Medicine Gospel Hospital, Busan, Korea

증례 : 이식신에서 발생한 허탈성사구체병증 (Collapsing Glomerulopathy) 1예

김지환1•정정임1•남주연1•김종인1•김중경1•정연순2•임 학2•정민정3

봉생병원 내과1, 고신대학교 의과대학 복음병원 내과2, 고신대학교 의과대학 복음병원 병리과3

Abstract

Collapsing glomeruopathy (CG) is a clinicopathologic variant of focal segmental glomerulosclerosis (FSGS) and is characterized by severe nephrotic syndrome, rapid progression to end stage renal disease, and features of visceral epithelial cell injury and glomerular capillary collapse. Such characteristics closely resemble those of HIV associated nephropathy. The frequency of CG has increased over the last decade. The cause of CG is unknown. The lesion has rarely been described in renal allografts with features similar to CG in native kidney. We recently identified allograft CG in a 44 year-old male patient who underwent biopsy for graft dysfunction after autodermic graft. The biopsy showed typical characteristics of CG. Serologically, the patient had no evidence of HIV infection. The renal function was not restored to normal in spite of methylprednisolone pulsing therapy. Now he is on conservative treatment with a functioning graft.

Key Words: Focal segmental glomerulosclerosis (FSGS), Nephrotic