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Collapsing glomerulopathy occurring in HIV-negative patients with systemic lupus erythematosus: report of three cases and brief review of the literature.

Abstract

Collapsing glomerulopathy (CG), once recognized as a distinct renal disease in HIV-positive patients, has since been described in association with a number of other conditions, including autoimmune diseases. Among the latter, CG has been reported in Still's disease. Extensive search of the literature revealed only three patients with renal biopsy diagnosis of CG in the presence of clinical and serological evidence of SLE (HIV-negative). This case report presents three adult female HIV-negative patients with SLE who were detected as having significant proteinuria and underwent renal biopsy. In all three cases, renal biopsy showed features of diffuse lupus nephritis. In addition, variable numbers of glomeruli showed segmental collapse of glomerular tuft with hyperplasia of overlying visceral epithelial cells and were diagnosed as CG. The patients were managed with aggressive immunosuppressive therapy, including intravenous steroids in two patients and tacrolimus and cyclophosphamide in one patient. All three patients achieved partial remission of proteinuria with maintained renal function at the last follow-up. Collapsing glomerulopathy is a rare occurrence in patients with SLE, which should be considered in patients with lupus nephritis and significant proteinuria. A timely performed renal biopsy allows accurate diagnosis and appropriate therapeutic modifications.

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  • Authors+Show Affiliations

    ,

    Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

    , , , , ,

    Source

    Lupus 20:8 2011 Jul pg 866-70

    MeSH

    Adolescent
    Adult
    Biopsy
    Female
    Glomerulosclerosis, Focal Segmental
    HIV Seropositivity
    Humans
    Kidney
    Lupus Erythematosus, Systemic
    Young Adult

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    21339242

    Citation

    Gupta, R, et al. "Collapsing Glomerulopathy Occurring in HIV-negative Patients With Systemic Lupus Erythematosus: Report of Three Cases and Brief Review of the Literature." Lupus, vol. 20, no. 8, 2011, pp. 866-70.
    Gupta R, Sharma A, Bhowmik D, et al. Collapsing glomerulopathy occurring in HIV-negative patients with systemic lupus erythematosus: report of three cases and brief review of the literature. Lupus. 2011;20(8):866-70.
    Gupta, R., Sharma, A., Bhowmik, D., Gupta, S., Agarwal, S., Gupta, R., & Dinda, A. (2011). Collapsing glomerulopathy occurring in HIV-negative patients with systemic lupus erythematosus: report of three cases and brief review of the literature. Lupus, 20(8), pp. 866-70. doi:10.1177/0961203310388446.
    Gupta R, et al. Collapsing Glomerulopathy Occurring in HIV-negative Patients With Systemic Lupus Erythematosus: Report of Three Cases and Brief Review of the Literature. Lupus. 2011;20(8):866-70. PubMed PMID: 21339242.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Collapsing glomerulopathy occurring in HIV-negative patients with systemic lupus erythematosus: report of three cases and brief review of the literature. AU - Gupta,R, AU - Sharma,A, AU - Bhowmik,Dm, AU - Gupta,S, AU - Agarwal,Sk, AU - Gupta,R, AU - Dinda,Ak, Y1 - 2011/02/21/ PY - 2011/2/23/entrez PY - 2011/2/23/pubmed PY - 2011/10/26/medline SP - 866 EP - 70 JF - Lupus JO - Lupus VL - 20 IS - 8 N2 - Collapsing glomerulopathy (CG), once recognized as a distinct renal disease in HIV-positive patients, has since been described in association with a number of other conditions, including autoimmune diseases. Among the latter, CG has been reported in Still's disease. Extensive search of the literature revealed only three patients with renal biopsy diagnosis of CG in the presence of clinical and serological evidence of SLE (HIV-negative). This case report presents three adult female HIV-negative patients with SLE who were detected as having significant proteinuria and underwent renal biopsy. In all three cases, renal biopsy showed features of diffuse lupus nephritis. In addition, variable numbers of glomeruli showed segmental collapse of glomerular tuft with hyperplasia of overlying visceral epithelial cells and were diagnosed as CG. The patients were managed with aggressive immunosuppressive therapy, including intravenous steroids in two patients and tacrolimus and cyclophosphamide in one patient. All three patients achieved partial remission of proteinuria with maintained renal function at the last follow-up. Collapsing glomerulopathy is a rare occurrence in patients with SLE, which should be considered in patients with lupus nephritis and significant proteinuria. A timely performed renal biopsy allows accurate diagnosis and appropriate therapeutic modifications. SN - 1477-0962 UR - https://www.unboundmedicine.com/medline/citation/21339242/Collapsing_glomerulopathy_occurring_in_HIV_negative_patients_with_systemic_lupus_erythematosus:_report_of_three_cases_and_brief_review_of_the_literature_ L2 - http://journals.sagepub.com/doi/full/10.1177/0961203310388446?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -