Acute rejection presenting as nephrotic syndrome.
BACKGROUND
Early diagnosis and treatment of acute rejection is important to prevent continued renal injury. Acute rejection most commonly presents with asymptomatic rise in serum creatinine. Proteinuria associated with acute rejection is well established; however, there is limited documentation of the presentation of acute rejection as nephrotic syndrome in the literature.


RESULTS
We report a renal transplant patient who presented with early onset nephrotic syndrome without change in serum creatinine, whose allograft biopsy confirmed acute glomerulitis and vascular rejection. Treatment of the acute rejection was accompanied by resolution of the nephrotic syndrome. A second episode of acute rejection was also manifested as nephrotic range proteinuria.


CONCLUSIONS
The nephrotic syndrome in early post-transplantation period should prompt a work-up for acute rejection even in the absence of the common findings of this complication.
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock 72205, USA. ahmadibrahim@exchange.uams.edu
I
I
Ahmad
S R
SR
Abul-Ezz
P D
PD
Walker
S M
SM
Bonsib
B
B
Ketel
Y M
YM
Barri
D000208:Acute Disease; D000328:Adult; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000209:etiology; D006084:Graft Rejection; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D016853:Muromonab-CD3 / Q000627:therapeutic use; D009404:Nephrotic Syndrome / Q000209:etiology*; D011507:Proteinuria / Q000209:etiology
D016853:Muromonab-CD3