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Go back to clinical information and images Diagnosis: Collapsing Glomerulopathy Collapsing glomerulopathyu (CG) is a morphologic lesion representing a common endpoint from multiple etiologies. It is a podocytopathy that is often secondary to APOL1 risk variants but has also been associated with infection, drugs, ischemia, hematologic neoplasia and autoimmune disease. Morphological features of CGP are time-tested and well-recognized today. However, there are several confounding morphologies that may provide diagnostic difficulty. The discovery of APOL1 risk variants changed the way we understand and classify CGP and provide, in part, a unifying etiology for some of the underlying associations, leading to a more pathogenesis-based approach to this multifaceted diagnosis (Nicholas Cossey L, et al. Collapsing glomerulopathy: a 30-year perspective and single, large center experience. Clin Kidney J. 2017;10(4):443-449. [PubMed link]). The term “collapsing glomerulopathy” was used for the first time in 1986, and it was assumed to be a variant of FSGS. However, CG is frequently an aggressive disease, with massive proteinuria and rapid progression to chronic renal disease. The notoriously more aggressive outcome in CG that in the other variants of FSGS, and the phenotypic features of podocytes indicating a different pathogenesis, have led some authors to considere that CG is not a variant of FSGS, but another glomerular alteration. See the chapter: Focal Segmental Glomerulosclerosis of our Tutorial.
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