Revista Médica del Instituto Mexicano del Seguro Social

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Revista Médica del Instituto Mexicano del Seguro Social >Year 2009, Issue 1

Velásquez-Jones L, Romero-Silva L, Ramón-García G, Portillo-Carrillo M, Valverde-Rosas S, Romero-Navarro B, Valencia-Mayoral P
Focal Segmental Glomerulosclerosis Related to BK Virus in a Child with Nephritic Syndrome. A Case Report
Rev Med Inst Mex Seguro Soc 2009; 47 (1)

Language: Español
References: 22
Page: 95-100
PDF: 345.33 Kb.

Full text


Background: focal segmental glomerulosclerosis (FSGS) is observed in about 10 % of children with idiopathic nephrotic syndrome; this disorder is usually resistant to corticoid therapy. In the last few years, five histological types of FSGS have been recognized; the collapsing nephropathy type is characterized by a rapid evolution to chronic renal failure.
Clinical case: a four years old boy presented with an irrelevant past history; eight months before admission he developed idiopathic nephrotic syndrome. He was treated with steroids without improvement, and a renal biopsy was performed in which minimal glomerular changes were found. Despite combined immunosuppressive treatment, he developed renal failure, septic shock and death. Collapsing nephropathy was demonstrated by immunohistochemistry, light and electron microscopy; renal new human papovirus (BK) infection was also found in the postmortem study.
Conclusions: collapsing nephropathy is an aggressive disorder resistant to immunosuppressive treatment, as occurred in our patient. Although some viral diseases have been associated with collapsing nephropathy, to our knowledge, BK infection has not been previously described in those patients.

Key words: nephrotic syndrome, glomerulosclerosis, focal segmental, renal insufficiency, chronic, kidney failure, BK virus, child.


  1. Falk RJ, Jennette JC, Nachman PH. Glomerulopatías primarias. En: Brenner BM, editor. El riñón. Tratado de nefrología. Séptima edición. Madrid: Elsevier; 2005. p. 1292-1380.

  2. Schlesinger ER, Sultz HE, Mosher WE, Feldman JG. The nephrotic syndrome: its incidence and implications for the community. Am J Dis Child 1968;116(6):623-632.

  3. Hodson EM, Knight JF, Willis NS, Craig JC. Corticosteroid therapy in nephrotic syndrome: a meta-analysis of randomized controlled trials. Arch Dis Child 2000;83(1):45-51.

  4. A report of the International Study of Kidney Disease in Children. The primary nephrotic syndrome in children. Identification of patients with minimal change nephrotic syndrome from initial response to prednisone. J Pediatr 1981; 98(4):561-564.

  5. Weiss MA, Daquioag E, Margolin EG, Pollak VE. Nephrotic syndrome, progressive irreversible renal failure, and glomerular “collapse”. A new clinicopathologic entity? Am J Kidney Dis 1986;7(1):20-28.

  6. Valeri A, Barisoni L, Appel B, Seigle R, D’Agati V. Idiopathic collapsing focal segmental glomerulosclerosis: a clinicopathologic study. Kidney Int 1996;50(5):1734-1746.

  7. Detwiler RK, Falk RJ, Hogan SL, Jennette JC. Collapsing glomerulopathy: a clinically and pathologically distinct variant of focal segmental glomerulosclerosis. Kidney Int 1994;45(5):1416-1424.

  8. Rossini M, Fogo AB. Interpreting segmental glomerular sclerosis. Curr Diag Pathol 2004;10:1-10.

  9. Barosini L, Mundel P. Podocyte biology and the emerging understanding of podocyte diseases. Am J Nephrol 2003;23(5):353-360.

  10. Singh HK, Baldree LA, Mckenney D, Hogan SL, Harris HA, Jennette JC. Idiopathic collapsing glomerulopathy (ICG) in the pediatric population: a report of six cases. Laboratory Invest 1997;76: 179A.

  11. Gipson DS, Chin H, Presler TP, Jennette C, Ferris ME, Massengill S, et al. Differential risk of remission and ESRD in childhood FSGS. Pediatr Nephrol 2006;21(3):344-349.

  12. D’Agati VD, Fogo AB, Bruijn JA, Jennete JC. Pathologic classification of focal segmental glomerulosclerosis: a working proposal. Am J Kidney Dis 2004;43(2):368-382.

  13. A report of the Southwest Pediatric Nephrology Study Group. Focal segmental glomerulosclerosis in children with idiopathic nephrotic syndrome. Kidney Int 1985;27(2):442-449.

  14. Velásquez JL, Dobras RB, Ocotitla J, Zavala N, Ramón GG, Romero NB, et al. Tratamiento con ciclosporina en niños con síndrome nefrótico corticorresistente. Bol Med Hosp Infant Mex 1996;53:109-116.

  15. Thomas DB, Franceschini N, Hogan SL, ten Holder S, Jennette CE, Falk RJ, et al. Clinical and pathologic characteristics of focal segmental glomerulosclerosis pathologic variants. Kidney Int 2006;69(5):920-926.

  16. Gardner SD, Field AM, Coleman DV, Hulme B. New human papovavirus (BK) isolated from urine after renal transplantation. Lancet 1971;19(7712):253-1257.

  17. Purighalla R, Shapiro R, McCauley J, Randhawa P. BK virus infection in a kidney allograft diagnosed by needle biopsy. Am J Kidney Dis 1995; 26(4):671-673.

  18. Hariharan S. BK virus nephritis after renal transplantation. Kidney Int 2006;69(4):655-662.

  19. Meyrier A. Mechanisms of disease: focal segmental glomerulosclerosis. Nature Clin Pract Nephrol 2005;1(1):44-54.

  20. Herman ES, Klotman PE. HIV-associated nephropathy: epidemiology, pathogenesis and treatment. Semin Nephrol 2003;23(2):200-208.

  21. Meyrier A. Nephrotic focal segmental glomerulosclerosis in 2004: an update. Nephrol Dial Transplant 2004;(10):2437-2444.

  22. Ruf RG, Schultheiss M, Lichtenberger A, Karle SM, Zalewski I, Mucha B, et al. Prevalence of WT1 mutations in a large cohort of patients with steroid- resistant and steroid-sensitive nephrotic syndrome. Kidney Int 2004;66(2):564-570.

>Journals >Revista Médica del Instituto Mexicano del Seguro Social >Year 2009, Issue 1

· Journal Index 
· Links 

Copyright 2019