A 35-year-old HIV-positive man presents with nephrotic-range proteinuria. Renal biopsy shows focal segmental glomerulosclerosis with collapse of capillary loops and overlying podocyte hypertrophy. This pattern is called:

• A Tip variant FSGS
• B Collapsing glomerulopathy (collapsing FSGS) ✓
• C Perihilar variant FSGS
• D Cellular variant FSGS

Explanation

Collapsing glomerulopathy is the most severe FSGS variant, characterised by global or segmental collapse of glomerular capillaries with overlying podocyte hypertrophy and hyperplasia. It is strongly associated with HIV nephropathy (HIVAN) and APOL1 high-risk genotypes in people of African ancestry, and carries the worst prognosis among FSGS variants. Tip variant has the best prognosis.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.