Allograft membranous glomerulonephritis and renal-vein thrombosis in a patient with a lupus anticoagulant factor.
A circulating lupus anticoagulant factor was detected in a 38-year-old man with end-stage renal disease and a 'lupus-like' syndrome with a diffuse proliferative glomerulonephritis. When treated with steroids, the 'lupus' complications were controlled and the anticoagulant factor disappeared; however, renal function did not recover and the patient commenced regular haemodialysis. Four months later the patient received a cadaver kidney transplant. At transplantation and during follow-up there was neither clinical nor laboratory evidence of lupus activity, but 19 months after transplantation, when steroids were tapered to a low dose, the lupus anticoagulant factor was detected, and renal-vein thrombosis complicated by sepsis led to the patient's death. A membranous glomerulonephritis was found on autopsy. This is the first time in which a (probably 'de novo') membranous glomerulonephritis has been detected in the allograft of a patient with circulating lupus anticoagulant factor.
Liaño
F
F
Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
Mampaso
F
F
García Martín
F
F
Pardo
A
A
Orte
L
L
Teruel
J L
JL
Quereda
C
C
Ortuño
J
J
D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D001779:Blood Coagulation Factors / Q000032:analysis / Q000276:immunology*; D015432:Glomerulonephritis, Membranoproliferative / Q000150:complications* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007678:Kidney Glomerulus / Q000648:ultrastructure; D016030:Kidney Transplantation; D016682:Lupus Coagulation Inhibitor; D008297:Male; D006435:Renal Dialysis; D012082:Renal Veins; D013927:Thrombosis / Q000209:etiology* / Q000276:immunology
D001323:Autoantibodies; D001779:Blood Coagulation Factors; D016682:Lupus Coagulation Inhibitor