Podocyte infolding glomerulopathy in a school-aged child.

Area of Science:

• Nephrology
• Pathology

Background:

• Podocyte infolding glomerulopathy (PIG) is a rare kidney disorder.
• Characterized by podocyte process infolding into the glomerular basement membrane.
• Presents with nephrotic syndrome, but pathogenesis and clinical implications are poorly understood due to limited reports, predominantly from Japan.

Purpose of the Study:

• To report a case of PIG in a pediatric patient from the Indian subcontinent.
• To describe the clinical presentation, diagnosis, and treatment response.
• To contribute to the limited global literature on PIG.

Main Methods:

• A 5-year-old boy presented with hypertension, edema, and nephrotic range proteinuria.
• Kidney biopsy confirmed PIG with characteristic microtubule formation in the glomerular basement membrane.
• Treatment involved initial prednisolone followed by the addition of tacrolimus.

Main Results:

• The patient exhibited hypertension, edema, nephrotic range proteinuria, and later macroscopic hematuria.
• Prednisolone monotherapy was ineffective.
• Addition of tacrolimus led to significant improvements in proteinuria and hematuria.

Conclusions:

• This case expands the understanding of PIG in a region with limited prior documentation.
• Tacrolimus demonstrated efficacy in managing PIG symptoms, offering a potential treatment option.
• Further research is needed to establish standardized treatment protocols for PIG.