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...he present case revealed the presence of a tip-variant of FSGS. The possible relationship between minimal-change disease (MCD) and the tip-variant of FSGS has been recently noted by different authors =-=[13]-=-. MCD and the tip-variant of FSGS are very unique forms of podocytopathy that share, among other characteristics, the abrupt onset and the sensitivity to steroids. Almost 40 years ago, and based only ...

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...pt onset and the sensitivity to steroids. Almost 40 years ago, and based only on clinical observations, Shalhoub proposed that MCD is a systemic disorder of T cell function and cell-mediated immunity =-=[14]-=-. Although not fully understood, in support of this hypothesis, a number of functional assays for T cells have been proved to be abnormal in some patients with active MCD. Using more contemporary tech...

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...nisms by which TRIs form have been elucidated through the study of lymphoblastic cell lines in response to elevated alpha- and beta-interferon levels [7] or in response to exogenous gamma-interferons =-=[8]-=-. Interferon levels display a log linear relationship to the number of TRIs based on the dose and duration of exposure [7]. The presence of TRIs is a marker of systemic stimulation by endogenous or ex...

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...esist microbial infections via TLR-4 that leads to high blood levels of interferons [9]. In the collapsing variant of FSGS, the identification of TRIs has been strongly associated with HIV infections =-=[10]-=-. The presence of TRIs is much higher in patients with HIV, systemic lupus erythematosus (SLE) and in those on interferon therapy (80–90%) compared with the general patient population (<5%) [8]. In pa...

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...cited by the host where the virus efficiently adapts to its immune system. As a result, CMV is never eliminated from the infected immunocompetent individual, causing persistent asymptomatic infection =-=[12]-=-. CMV is able to infect several cell types, including endothelial cells, epithelial cells (plus retinal cells), smooth muscle cells, fibroblasts, leukocytes and dendritic cells. It has not been demons...

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...slow taper (12–16 weeks). Discussion TRIs/structures were first described in the renal biopsies of patients with SLE [1] considered to be viral particles because of their resemblance to paramyxovirus =-=[1, 2]-=-. The term ‘tubuloreticular structures’ was first suggested by A. J. Dalton in 1971 [2]. This distinctive 23–25 nm subcellular organelle is outlined by anastomosing tubular structures. Commonly locate...

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...er, Chinese licorice root, Astragalus Henrii, Panax ginseng and other variants are shown to enhance the ability to resist microbial infections via TLR-4 that leads to high blood levels of interferons =-=[9]-=-. In the collapsing variant of FSGS, the identification of TRIs has been strongly associated with HIV infections [10]. The presence of TRIs is much higher in patients with HIV, systemic lupus erythema...

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...vidence of active CMV disease. The patient was given prednisone (12 weeks), with a slow taper (12–16 weeks). Discussion TRIs/structures were first described in the renal biopsies of patients with SLE =-=[1]-=- considered to be viral particles because of their resemblance to paramyxovirus [1, 2]. The term ‘tubuloreticular structures’ was first suggested by A. J. Dalton in 1971 [2]. This distinctive 23–25 nm...

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...nship to the number of TRIs based on the dose and duration of exposure [7]. The presence of TRIs is a marker of systemic stimulation by endogenous or exogenous interferons, as interferon ‘footprints’ =-=[3]-=-. In the kidney, TRIs are frequently seen in the glomerular endothelial cells of renal allografts and in the native kidneys of patients with autoimmune diseases [2], viral infections [7] and in those ...

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...ic polymyositis, dermatomyositis, scleroderma, Sjögren’s) and viral infections (HIV, hepatitis B and C) [2]. In addition, its presence has been observed in tumors, especially sarcomas (like Kaposi’s) =-=[5]-=-, other diseases (infectious mononucleosis, histiocytosis X) and renal allografts. TRIs are almost always seen in the tissues of patients with HIV/AIDS, sometimes even before the diagnosis/manifestati...

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...infectious mononucleosis, histiocytosis X) and renal allografts. TRIs are almost always seen in the tissues of patients with HIV/AIDS, sometimes even before the diagnosis/manifestation of the disease =-=[6]-=-. The mechanisms by which TRIs form have been elucidated through the study of lymphoblastic cell lines in response to elevated alpha- and beta-interferon levels [7] or in response to exogenous gamma-i...

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...gnosis/manifestation of the disease [6]. The mechanisms by which TRIs form have been elucidated through the study of lymphoblastic cell lines in response to elevated alpha- and beta-interferon levels =-=[7]-=- or in response to exogenous gamma-interferons [8]. Interferon levels display a log linear relationship to the number of TRIs based on the dose and duration of exposure [7]. The presence of TRIs is a ...

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...opulation (<5%) [8]. In patients with membranous nephropathy, the presence of TRIs has been associated with secondary forms (autoimmune disease, hepatitis, H. pylori infection, diabetes and lymphoma) =-=[11]-=-. To date, the presence of TRIs in the endothelial cells of interstitial capillaries has only been associated with HIV disease [10]. CMV is a highly prevalent, globally occurring infection that rarely...

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...2]. This epiphenomenon may have relevance in the development of podocyte damage associated with CMV infection. The diagnosis of viral-related nephropathies requires a high index of clinical suspicion =-=[15]-=-. CMV systemic infection is an uncommon cause of nephropathy. The association of CMV systemic infection with FSGS was previously reported in the renal allograft in a patient with CMV viremia and nephr...

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...c syndrome. Similar to the findings in our case, there were no CMV viral cytopathic changes, however, ultrastructural examination revealed numerous endothelial TRIs and severe foot process effacement =-=[16]-=-. There are also a few case reports of CMV infection being linked to collapsing glomerulopathy, the most aggressive variant of primary podocyte disease, in immunocompetent non-transplant patients [16]...