American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which condition is typically associated with collapsing FSGS?

Diabetes Mellitus
Hypertension
HIV infection
Systemic Lupus Erythematosus

The correct answer is: HIV infection

Collapsing focal segmental glomerulosclerosis (FSGS) is indeed most commonly associated with HIV infection. This specific variant of FSGS is characterized by significant podocyte injury and is often seen in patients with HIV-associated nephropathy. The relationship is thought to be due to direct viral effects on podocytes or secondary to the immune response within the kidney. In the context of the other conditions, while diabetes mellitus and hypertension can lead to different forms of kidney damage, they are not specifically linked to the collapsing variant of FSGS. Additionally, in systemic lupus erythematosus (SLE), the types of kidney injury seen are usually related to lupus nephritis, which has a different histological profile than collapsing FSGS. Thus, the distinction of HIV as a primary factor for this specific form of glomerular disease underscores its important association in clinical practice.