Collapsing glomerulopathy: The Indian scenario

Sir,

We read with interest the case report by Naaz et al. describing the first case of collapsing glomerulopathy in an HIV positive patient in Kashmir.[1] This lesion is being increasingly diagnosed by nephropathologists at other centers in India, with increasing awareness of the morphologic changes.[2–4] With reference to the above, we would like to mention that collapsing glomerulopathy is the commonest renal lesion associated with HIV; however, it is not HIV alone that causes this pathomorphologic insult. This assortment of pathologic changes is also seen in association with a myriad of other illnesses, namely infections including cytomegalovirus, Hepatitis C virus, and pulmonary tuberculosis; autoimmune disorders such as Systemic Lupus and adult Still's disease; malignancies including multiple myeloma and myeloid leukemia and with the use of drugs including interferon and pamidronate.[5] An increasing number of cases are also being diagnosed post-renal transplantation.[4] Identification of the lesion should be an indication of severe renal injury regardless of the causative etiology. Consciousness of this entity will enhance its diagnosis in the near future.