Kanodia Kamal V, Vanikar Aruna V, Patel Rashmi D, Suthar Kamlesh S, Nigam Lovelesh K, Patel Himanshu V, Kute Vivek, Trivedi Hargovind L
Professor, Department of Pathology, Lab Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India .
Professor and Head, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India .
J Clin Diagn Res. 2016 Apr;10(4):EC15-7. doi: 10.7860/JCDR/2016/17297.7646. Epub 2016 Apr 1.
Collapsing Glomerulopathy (CG) is recognized as distinct pattern of proliferative parenchymal injury with poor response to empirical therapy.
A single center retrospective study was carried out to find out clinicopathological features of idiopathic CG.
A total of 3335 native renal biopsies were analyzed retrospectively which were performed from 2008 to 2014 with emphasis on clinicopathological correlation and histopathological presentation.
Idiopathic CG constituted 0.75% incidence (25 out of 3335 biopsies) of all biopsies, adults constituting major study part with 88%. The duration of the symptoms at the time of biopsy was 34.12±26.09 days and 35±22.91 days respectively in adults and children. Hypertension was noted in 9(40.9%) and oliguria in 8(36.4%) in adults. Urinalysis revealed microscopic haematuria 12(54.5%) in adults. Nephrotic range proteinuria was reported in 10 (45.5%) adult patients. Glomerular collapse with hyperplasia/ hypertrophy of podocytes was seen in 4.54±3.11 glomeruli. Tubular microcystic dilation was seen in 16(64%) patients. Tubular atrophy involving mild (t1) in 15(60%), moderate (t2) in 4(16%) and severe (t3) in 6(24%) patients. Interstitial fibrosis was mild (i1) in 17(68%), moderate (i2) in 2(8%) and severe (i3) in 6(24%) patients.
Idiopathic CG is a morphological pattern of grave podocyte injury with poor prognosis. However, there are chances of remission/ recovery if the tubular atrophy and interstitial fibrosis are of grades ≤ t1 i1.
塌陷性肾小球病（CG）被认为是一种增殖性实质损伤的独特模式，对经验性治疗反应不佳。
进行一项单中心回顾性研究，以找出特发性CG的临床病理特征。
回顾性分析了2008年至2014年期间共3335例肾活检标本，重点关注临床病理相关性和组织病理学表现。
特发性CG占所有活检病例的0.75%（3335例活检中有25例），其中成年人占主要研究部分，为88%。成人和儿童活检时症状持续时间分别为34.12±26.09天和35±22.91天。成人中9例（40.9%）有高血压，8例（36.4%）有少尿。尿液分析显示成人中有12例（54.5%）镜下血尿。10例（45.5%）成年患者出现肾病范围蛋白尿。在4.54±3.11个肾小球中可见肾小球塌陷伴足细胞增生/肥大。16例（64%）患者出现肾小管微囊性扩张。15例（60%）患者肾小管萎缩为轻度（t1），4例（16%）为中度（t2），6例（24%）为重度（t3）。17例（68%）患者间质纤维化轻度（i1），2例（8%）为中度（i2），6例（24%）为重度（i3）。
特发性CG是一种严重的足细胞损伤形态模式，预后不良。然而，如果肾小管萎缩和间质纤维化程度≤t1 i1，则有缓解/恢复的机会。
