A 45-year-old man with a history of intravenous drug use presents with nephrotic syndrome and HIV infection. Renal biopsy shows collapsing glomerulopathy with collapse of the glomerular tuft and prominent podocyte hyperplasia. This pattern is most characteristic of which condition?
- A HIV-associated nephropathy (HIVAN) ✓
- B Heroin nephropathy
- C Diabetic nephropathy
- D Amyloidosis
Correct answer: A. HIV-associated nephropathy (HIVAN)
Explanation
HIV-associated nephropathy classically shows collapsing FSGS pattern with global collapse of the glomerular tuft, prominent podocyte hyperplasia, and microcystic tubular dilatation. Heroin-associated FSGS typically shows segmental (not global) collapse without prominent podocyte hyperplasia. Diabetic nephropathy shows mesangial expansion and Kimmelstiel-Wilson nodules. Amyloidosis shows amorphous Congo red-positive deposits.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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