Challenges in clinical-pathologic correlations: Acute tubular necrosis in a patient with collapsing focal and segmental glomerulosclerosis mimicking rapidly progressive glomerulonephritis

• Published in: Renal failure Vol. 32; no. 8; pp. 1005 - 1008
• Main Authors: Rodamilans, Mariana Freire, Barros, Luisa Leite, Carneiro, Marcia M., dos Santos, Washington Luis Conrado, Rocha, Paulo Novis
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.09.2010
• Subjects: Diagnosis, Differential; Female; Glomerulonephritis - diagnosis; Glomerulonephritis - etiology; Glomerulonephritis - therapy; Glomerulosclerosis, Focal Segmental - diagnosis; Glomerulosclerosis, Focal Segmental - etiology; Glomerulosclerosis, Focal Segmental - therapy; Humans; Kidney Tubular Necrosis, Acute - diagnosis; Kidney Tubular Necrosis, Acute - etiology; Kidney Tubular Necrosis, Acute - therapy; Middle Aged
• ISSN: 0886-022X; 1525-6049
• DOI: 10.3109/0886022X.2010.501931

Herein, we report a case of acute kidney injury (AKI) due to diarrhea-induced acute tubular necrosis (ATN) in a patient with nephrotic syndrome secondary to biopsy-proven collapsing focal and segmental glomerulosclerosis (FSGS). The clinical picture mimicked rapidly progressive glomerulonephritis (RPGN) and motivated pulse therapy with methylprednisolone and cyclophosphamide. The case presentation is followed by a brief overview of the epidemiology of AKI in nephrotic syndrome as well as a discussion of its risk factors and potential mechanisms involved.