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BioMed Research International
Volume 2016, Article ID 7351964, 8 pages
http://dx.doi.org/10.1155/2016/7351964
Review Article

Infection-Related Focal Segmental Glomerulosclerosis in Children

Department of Pediatric Nephrology, University Children’s Medical Clinic, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

Received 25 December 2015; Revised 7 April 2016; Accepted 21 April 2016

Academic Editor: Sivagnanam Thamilselvan

Copyright © 2016 Anne Katrin Dettmar and Jun Oh. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Focal segmental glomerulosclerosis (FSGS) is the most common cause of steroid resistant nephrotic syndrome in children. It describes a unique histological picture of glomerular damage resulting from several causes. In the majority of patients the causing agent is still unknown, but in some cases viral association is evident. In adults, the most established FSGS causing virus is the human immune-deficiency virus, which is related to a collapsing variant of FSGS. Nevertheless, other viruses are also suspected for causing a collapsing or noncollapsing variant, for example, hepatitis B virus, parvovirus B19, and Cytomegalovirus. Although the systemic infection mechanism is different for these viruses, there are similarities in the pathomechanism for the induction of FSGS. As the podocyte is the key structure in the pathogenesis of FSGS, a direct infection of these cells or immediate damage through the virus or viral components has to be considered. Although viral infections are a very rare cause for FSGS in children, the treating pediatric nephrologist has to be aware of a possible underlying infection, as this has a relevant impact on therapy and prognosis.