Collapsing glomerulopathy in renal allograft biopsies: A study of five cases

 

R P Senthil Kumar, K Senthil Kumar^*, V Balaraman, S Tirumalvalavan, Murugesan

 

Abstract              Collapsing glomerulopathy (CG) is considered to be a distinct clinic pathologic pattern of proliferative podocyte injury. The clinical significance of CG in renal allograft biopsies is not yet clear due to the scant data on the occurrence of CG in renal transplant recipients. We identified nine cases of CG in allograft biopsies over a period of 1 year. Detailed clinical information, including follow-up data, was collected and histopathological analysis performed. All the five patients were males with a mean age at diagnosis of 37.8 years. The median post transplantation duration at diagnosis was 36 (range 12–84) months. All the patients presented with severe proteinuria and graft dysfunction. Histological analysis showed a median number of 7 glomeruli. The collapse of the glomerular tuft with visceral epithelial cell hyperplasia involved median of 2 glomeruli (range 1–4). At the last follow-up (mean duration 6 months), two patients had graft failure (return to dialysis) while three had functioning grafts. This series emphasizes the importance of this rare glomerular pathology as an important cause of graft dysfunction that may lead to allograft failure.

Key Word: Collapsing glomerulopathy, histopathology, outcome, renal allograft.