A 40-year-old man with IV drug abuse develops nephrotic syndrome. Renal biopsy shows focal segmental glomerulosclerosis with collapse of the glomerular tuft and prominent podocyte hypertrophy and hyperplasia. Which FSGS variant is this?
- A FSGS, NOS (not otherwise specified) variant
- B Tip lesion FSGS
- C Collapsing FSGS ✓
- D Cellular FSGS
Correct answer: C. Collapsing FSGS
Explanation
Collapsing FSGS is characterized by segmental or global collapse of the glomerular capillary tuft accompanied by overlying podocyte hypertrophy and hyperplasia. It is the hallmark of HIV-associated nephropathy (HIVAN) and carries the worst prognosis among FSGS variants. Tip lesion FSGS affects the tubular pole and has a better prognosis. IV drug abuse predisposes to HIV infection, hence collapsing FSGS.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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