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Letters to Editor
22 (
2
); 151-151

Authors’ reply

Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
Department of Nephrology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
Address for correspondence: Dr. Amit K. Dinda, Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110 029, India. E-mail: amit_dinda@yahoo.com

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This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.

Sir,

We have read the comments[1] offered on our article. We agree completely that collapsing glomerulopathy (CG) may finally be accepted as a distinct entity with no relation to focal and segmental glomerulosclerosis (FSGS). We would like to clarify that the global sclerosis in the article refers to obsolescent glomeruli and not to global collapse. We did not observe global collapse in any of our cases. Systemic lupus erythematosus was excluded on the basis of clinical and serological features in the case with immune complex deposition.

We agree that a short follow-up period may be an additional factor for the favorable outcome in our study. However, a study by Stokes et al.[2] showed high frequency of graft failure within 3–4 months of diagnosis of CG. In comparison to these results, our patients had a favorable outcome.

It is somewhat difficult to clearly outline the etiologic factors of CG in our cases. Vascular lesions definitely play a role in the pathogenesis of CG by causing ischemia and glomerular collapse, as has been described in native kidneys as well. Other factors such as viral infections and drug toxicities may also be involved.

Although serum creatinine in 5 cases (cases 2, 3, 6, 7, 8) was less than 2.0 mg/dL, there was a significant rise from the baseline creatinine value. Proteinuria we agree is moderate to severe.

We thank the authors for pointing out the discrepancies in numbers at certain places and regret the typographical errors. The correct duration is of post-transplant duration and follow-up are 12–98 and 3–12 months, respectively. The follow-up creatinine values ranged between 1.4 and 2.1 mg/dL.

References

  1. , . Collapsing glomerulopathy in renal allograft biopsies: A study of nine cases. Indian J Nephrol. 2012;22:150.
    [Google Scholar]
  2. , , , . Collapsing glomerulopathy in renal allografts: A morphological pattern with diverse clinicopathologic associations. Am J Kidney Dis. 1999;33:658-66.
    [Google Scholar]

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