Case Report Collapsing Focal Segmental Glomerulosclerosis in a Patient with Systemic Lupus Erythematosus Hassan Tariq, Arsalan Rafiq, and Giovanni Franchin Bronx Lebanon Hospital Center, Department of Medicine, 1650 Selwyn Avenue, Suit 10C, Bronx, NY 10457, USA Correspondence should be addressed to Hassan Tariq; htariq@bronxleb.org Received 31 May 2014; Revised 15 July 2014; Accepted 29 July 2014; Published 11 August 2014 Academic Editor: W. Zidek Copyright © 2014 Hassan Tariq et al. his 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. We present a case of a 36-year-old female from Ghana who presented with atypical chest pain and shortness of breath and was found to have bilateral transudative pleural efusion and trivial pericardial efusion. Further work-up revealed serological markers consistent with active lupus and negative HIV. She developed rapid deterioration of her renal function requiring dialysis. Her renal biopsy showed collapsing focal segmental glomerulosclerosis with difuse mesangial proliferative glomerulonephritis, consistent with lupus nephritis class II along with tubular degenerative changes. She was started on high dose steroids and later on mycophenolate mofetil. Her renal function slowly recovered to baseline. 1. Introduction Collapsing glomerulopathy is segmental or global wrinkling and collapse of capillary walls and overlying epithelial cell proliferation [1]. When we trace back literature, irst cases trace back to 1979 which have been biopsy proven [2]. An increasing number of cases are being reported as awareness among health care professionals is increasing [3]. It is a podocytopathy with distinct clinicopathologic features from focal segmental glomerulosclerosis as the lesions are charac- terized by formation of pseudocrescents and by collapse of capillary loops rather than extracellular matrix accumulation and glomerulosclerosis being a late manifestation. hree variants have been described in the literature including idio- pathic, genetic, and reactive [4]. Collapsing glomeruloscle- rosis presents with proteinuria, resistant to most available treatments, and leads to rapid progression towards renal failure. he usual causes for this manifestation include viral infections, autoimmune disorders, or drugs. Here we present a case of a patient with collapsing glomerulosclerosis which will provide more insight and further research opportuni- ties in regard to the treatment of this distinct pathologic condition. 2. Case Presentation A 36-year-old black woman from Ghana presented to the ER with complaints of chest pain and shortness of breath for one day. She was returning from a vacation in Ghana when she experienced sudden onset of let-sided pleuritic chest pain during the light, followed by shortness of breath ater landing. She was diagnosed with Sjogren’s syndrome when she presented ive years earlier with a vasculitic rash of lower extremities which showed leukocytoclastic vasculitis on biopsy. At the time she had positive ANA at 1:1280 titer, positive rheumatoid factor, ESR and CRP elevated, anti- double stranded DNA negative, anti-SSA positive, anti-SSB positive, and normal complements. Except for a few recurrent episodes of rash in lower extremities which responded to steroids, she remained asymptomatic for a couple of years prior to the current admission. She had been recently admitted to a hospital in Ghana ater being found to have a let-sided pleural efusion and treated with chest tube insertion for presumed pneumonia. Review of systems and social history were noncontributory. Upon admission to our institution, she was afebrile and showed stable vital signs. Except for decrease breath sounds Hindawi Publishing Corporation Case Reports in Medicine Volume 2014, Article ID 732192, 5 pages http://dx.doi.org/10.1155/2014/732192