Collapsing focal segmental glomerulosclerosis (FSGS), or collapsing glomerulopathy (CG), responds poorly to commonly employed therapies, with a high proportion of patients progressing to end-stage renal disease. We report an adult in a nephrotic state, diagnosed with minimal-change disease on biopsy, who failed to respond to steroids, calcineurin inhibitors (CNIs), mycophenolate mofetil and cyclophosphamide. Repeat biopsy showed CG. Treatment with 4 weekly doses of rituximab led to sustained remission of his nephrotic state. This is the first report of adult-onset CG that has responded favourably to rituximab. Rituximab could be a treatment option for patients with this difficult-to-treat condition.

Immunoglobulin A (IgA) dominant postinfectious glomerulonephritis (IgA PIGN) is a distinct clinical entity increasingly recognized in adult. It usually presents with reduced glomerular filtration rate, heavy proteinuria, and has unfavorable prognosis. Immunofluorescence study of renal biopsy specimens have IgA as dominant or codominant antibody. We encountered two cases of IgA dominant PIGN recently presenting as rapidly progr essive glomerulonephritis and managed conservatively. Both the patients are on follow-up and do not have complete recovery of renal function till date. Long-term follow-up is needed to assess the progression of the disease in these patients.

Basal cell carcinoma is the most common nonmelanoma skin cancer. Its occurrence in the perianal region is very rare. Awareness of its benign behavior in this region, in contrast to the earlier reports, is vital in its management. Local excision seems to provide adequate control. We are herewith reporting an extremely rare case of a 69-year-old male with basal cell carcinoma treated adequately with local excision.

We describe a 21-year male with mood disorder on lithium therapy and psoriasis-like skin lesions presenting with rapidly progressive renal failure. The kidney biopsy showed acute tubulointerstitial nephritis with immunoglobulin G4-positive plasma cell infiltration. He was started on oral steroids with a provisional diagnosis of IgG4-related tubulointerstitial nephritis. All dermatological, psychiatric and renal manifestations dramatically improved, and he was taken off lithium. He had a relapse of his psychiatric symptoms on stopping steroids, and they again responded to steroids.

Renal involvement by lymphoma can be a diagnostic challenge. Acute kidney injury (AKI) is an unusual manifestation of lymphomatous infiltration in the kidneys. We report three cases of lymphoblastic lymphoma, a very rare form of lymphoma, presenting with AKI and bilateral enlargement of kidneys, diagnosed by percutaneous kidney biopsy. Lymphomatous infiltration should be suspected with such clinical presentation. Kidney biopsy is a valuable diagnostic tool, to establish the correct diagnosis and subtype of lymphoma for timely initiation of therapy for these aggressive hematological malignancies.