[Collapsing variant of focal segmental glomerulosclerosis by parvovirus B19: case report].
OBJECTIVE
To describe the clinical and laboratory profile of focal segmental glomerulosclerosis (FSGS) of the collapsing subtype in association with infection by parvovirus B19 (PVB19).


METHODS
Female patient, 37 years old, mulatto, developed pharyngalgia and fever with partial improvement after penicillin. After one week we observed reduced urinary output and lower limb edema. Smoker, family and personal history negative for hypertension, diabetes or kidney disease. Patient presented with olyguria, hypertension and edema, also hypochromic microcytic hypoproliferative anemia, nephritic range proteinuria, microscopic hematuria and renal dysfunction. All rheumatologic investigation, HIV and hepatitis serology were negative. Unremarkable renal ultrasound. PCR positive for PVB19 in bone marrow aspirate and blood and renal biopsy conclusive of collapsing FSGS subtype. Spontaneous remission occurred within two weeks of the profile. The blood PVB19 PCR was repeated within a month and resulted negative. This finding demonstrated PVB19 acute infection or viral reactivation in association with collapsing FSGS.


CONCLUSIONS
There is demonstrated the temporal association of PVB19 viremia and collapsing FSGS, due primary infection or viral reactivation. The association of collapsing FSGS and PVB19 is described in the literature, demonstrating virus presence in kidney tissue, but the real relationship of virus in the pathogenesis of this glomerulopathy remains unclear.
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
Geraldo Rubens Ramos de
GR
Freitas
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
Marcel Rodrigues Gurgel
MR
Praxedes
Faculdade de Medicina, Universidade de São Paulo, Brasil.
Denise
D
Malheiros
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
Leonardo
L
Testagrossa
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
Cristiane Bitencourt
CB
Dias
Faculdade de Medicina, Universidade de São Paulo, Brasil.
Viktoria
V
Woronik
D000328:Adult; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000145:classification* / Q000821:virology*; D006801:Humans; D010322:Parvoviridae Infections / Q000150:complications*; D016732:Parvovirus B19, Human