Reduction of post-transplant proteinuria due to recurrent mesangial proliferative (IgM) glomerulonephritis following plasma exchange.
A patient developed recurrent IgM proliferative glomerulonephritis and a nephrotic syndrome following HLA-identical living donor renal transplantation. Two intensive five-day courses of plasma exchange were followed by sustained reduction of proteinuria. Renal function has remained normal at all times. Immune complex sizing revealed a high titer of middle range complexes (mol. wt. 1 x 10(6) daltons app.); immune complex clearance following an antigen load was not improved by plasma exchange suggesting no alteration of reticulo-endothelial function. Possible mechanisms of benefit are discussed.
D000293:Adolescent; D001706:Biopsy; D005921:Glomerulonephritis / Q000150:complications / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male; D010951:Plasma Exchange; D011183:Postoperative Complications; D011507:Proteinuria / Q000209:etiology*
D007075:Immunoglobulin M