Acute cytomegalovirus infection complicated by collapsing glomerulopathy

Tomlinson, Laurie; Boriskin, Yu. S.; McPhee, Iain; Holwill, Stephen; Rice, Philip

doi:10.1093/ndt/18.1.187

Cited by 48 publications

(35 citation statements)

References 5 publications

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“…The patient did not receive antiviral therapy for CMV though the infection was cleared. His renal function did not improve; thus, the patient remained dialysis dependent [5]. …”

Section: Discussionmentioning

confidence: 99%

“…Cases occurring after renal transplantation and rare cases associated with autoimmune diseases, malignancies, interferon-α, pamidronate and genetic disorders have also been reported [1–3]. In addition, two cases suggesting an association between acute cytomegalovirus (CMV) infection and collapsing glomerulopathy have been reported previously [4, 5]. We present a case of collapsing glomerulopathy associated with acute CMV infection in an immunocompetent host requiring hemodialysis.…”

Section: Introductionmentioning

confidence: 90%

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Cytomegalovirus-induced collapsing focal segmental glomerulosclerosis

et al. 2012

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Collapsing glomerulopathy is an aggressive morphologic variant of focal segmental glomerulosclerosis which typically presents with nephrotic syndrome and rapidly progressive renal failure. Most cases of collapsing glomerulopathy are associated with human immunodeficiency virus infection. We present a rare case of collapsing glomerulopathy associated with acute cytomegalovirus (CMV) infection in an immunocompetent host with improvement in renal function after the treatment of CMV with ganciclovir. CMV may be an under-recognized cause of collapsing glomerulopathy which may respond to antiviral treatment.

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“…The patient did not receive antiviral therapy for CMV though the infection was cleared. His renal function did not improve; thus, the patient remained dialysis dependent [5]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Cytomegalovirus-induced collapsing focal segmental glomerulosclerosis

et al. 2012

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“…Among other factors, hemodynamic disturbances may play a role in the development of the pattern of CG in renal allografts. Cases of de novo CG have been observed in transplant patients with cytomegalovirus or parvovirus B19 infection (21,22) and most recently, associated with post-transplant antibodies to angiotensin II type 1 receptor occurring as a part of antibody-mediated rejection (23).…”

Section: Collapsing Glomerulopathymentioning

confidence: 99%

De Novo Glomerular Diseases after Renal Transplantation

Ponticelli

Moroni

Glassock

2014

Clinical Journal of the American Society of Nephrology

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Glomerular diseases developing in the kidney allograft are more often recurrences of the original disease affecting the native kidneys. However, in an undefined number of cases de novo, glomerular diseases unrelated to the original disease in the native kidneys can develop in the transplanted kidney. The clinical presentation and histologic features of de novo diseases are often similar to those features observed in patients with primary or secondary GN in the native kidneys. However, in transplanted kidneys, the glomerular, vascular, and tubulointerstitial changes are often intertwined with structural abnormalities already present at the time of transplant or caused by antibody-or cell-mediated allograft rejection, immunosuppressive drugs, or superimposed infection (most often of a viral nature). The pathophysiology of de novo glomerular diseases is quite variable. In rare cases of de novo minimal change disease, circulating factors increasing the glomerular permeability likely participate. Maladaptive hemodynamic changes and tissue fibrosis caused by calcineurin inhibitors or other factors may be involved in the pathogenesis of de novo FSGS. The exposure of cryptic podocyte antigens may favor the development of de novo membranous nephropathy. Many cases of de novo membranoproliferative GN are related to hepatitis C virus infection. Patients with Alport syndrome lacking antigenic epitopes in their glomerular basement membrane may develop antibodies against these glomerular basement membrane antigens expressed in the transplanted kidney. Infection may cause acute GN to have a heterogeneous clinical presentation and outcome. De novo pauci-immune GN in renal transplant is rare. Preexisting or acquired intolerance to glucose may, in the long term, cause diabetic nephropathy. The prognosis of de novo diseases depends on the type of GN, the severity of lesions caused by the alloimmune response, or the efficacy of immunosuppressive therapy. In most cases, the management of de novo glomerular diseases is empirical or elusive.

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“…Like other types of FSGS, the collapsing FSGS may be idiopathic in origin, or it may occur secondary to a variety of conditions that include human immunodeficiency virus (HIV) infection, hepatitic C virus infection, cytomegalovirus infection, intravenous drug abuse, systemic lupus erythematosus-like disorder, and multiple myeloma [3][4][5][6]. Very little has been published on the clinical outcome of idiopathic collapsing FSGS in children or in adults.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic collapsing focal segmental glomerulosclerosis in pediatric patients

et al. 2007

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The aim of this study was to evaluate the clinical outcome of our patients with idiopathic collapsing focal segmental glomerulosclerosis (FSGS) as compared to those with non-collapsing FSGS. The study included a total of 39 patients with idiopathic FSGS. Of these, 11 had collapsing FSGS and the remaining 28 were collectively grouped as non-collapsing FSGS. The mean ages, gender ratio (M:F), and percentage of African-American patients in collapsing versus non-collapsing FSGS groups were 12.7+/-3.1 and 8.9+/-5.1 years, 1.2:1 and 4.6:1, and 90.9 and 53.6%, respectively. After a mean followup period of 31.5+/-22.3 months, 8 patients (73%) with collapsing FSGS had chronic renal impairment as compared to 8 (29%) patients with non-collapsing FSGS group after a mean follow-up period of 18.7+/-12.9 months. However, the cumulated renal survival at 30 months did not reveal a significant difference. In comparison to non-collapsing FSGS, collapsing FSGS in our study was equally common in females as in males and occurred predominantly in African Americans. The outcome of our patients with collapsing FSGS at 30 months was better than in previous reports.

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Acute cytomegalovirus infection complicated by collapsing glomerulopathy

Cited by 48 publications

References 5 publications

Cytomegalovirus-induced collapsing focal segmental glomerulosclerosis

Cytomegalovirus-induced collapsing focal segmental glomerulosclerosis

De Novo Glomerular Diseases after Renal Transplantation

Idiopathic collapsing focal segmental glomerulosclerosis in pediatric patients

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