Collapsing glomerulopathy

Kidney nontumor
Primary glomerular diseases
Collapsing glomerulopathy

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 15 September 2017, last major update September 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Collapsing glomerulopathy [title]

Table of Contents

Cite this page: Sangle, N. Collapsing glomerulopathy. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneycollapsingglomerulo.html. Accessed April 22nd, 2018.

Definition / general

Resembles special form of focal and segmental glomerulosclerosis in IV drug abuse and AIDS (rapid progression to renal failure with severe proteinuria, poor response to treatment and similar microscopic changes) but HIV negative
Usually black men; associated with genetic variants in the nonmuscle myosin heavy chain 9 gene (MYH9) (Semin Nephrol 2010;30:111)
May be due to altered hemodynamics
Renal allografts: important cause of graft dysfunction that may lead to allograft failure (Indian J Nephrol 2011;21:10); similar histologic changes but process may have different origin (Hum Pathol 2002;33:437)
May be associated with various disorders, which may have podocyte injury in common: mixed connective tissue disease (Clin Nephrol 2011;75:32), natural killer cell leukeima (Am J Kidney Dis 2011;58:855), sickle cell disease (J Med Case Reports 2011;5:71), sirolimus treatment (Ann Transplant 2011;16:113), systemic lupus erythematosus or lupus-like disease (Clin J Am Soc Nephrol 2012;7:914), tuberculosis (Ren Fail 2010;32:143)

Case reports

58 year old man effectively treated with lisinopril and deflazacort (Clin Exp Nephrol 2010;14:385)

Microscopic (histologic) description

Accentuation of lobules due to widespread collapse of glomerular capillary loops with localized hyperplasia and hypertrophy of epithelial cells overlying sclerotic segment
Cells are vacuolated and swollen, contain abundant resorption droplets
Severe tubulointerstitial injury with degenerative changes, dilated tubules, tubular casts and lymphocytic infiltrate

Microscopic (histologic) images

Images hosted on other servers:

Collapsed glomerulus

With sickle cell disease

Various images

Immunofluorescence

Segmental IgM and C3

Electron microscopy description

Wrinkling but little / no basement membrane thickening; marked podocyte hypertrophy; no electron dense deposits of tubuloreticular inclusions (compared to HIV associated nephropathy)