Diffuse glomerular basement membrane lamellation in post-transplant IgA nephropathy.
Diffuse glomerular basement membrane (GBM) lamellation, reminiscent of Alport's syndrome, has rarely, and exclusively, been reported in renal allografts from pediatric donors to adult recipients. We report on a similar lesion, identified in a 42-year-old male, who received a kidney from an unrelated 21-year-old living male donor. The disease of the recipient was unknown. Renal allograft biopsies were performed 3.5 and 4.8 years after the renal transplantation, due to massive proteinuria and serum creatinine elevation. The histological features of both biopsies were similar, but more advanced in the second biopsy. Glomerular mesangium was widened and had an IgA deposit in the first biopsy. In addition to the presence of mesangial electron dense deposits, the GBM showed diffuse lamellation and splintering on the subepithelial side, but no definite deposits. In the second biopsy, IgA deposits were extended to the peripheral capillary walls, but electron microscopic examination was not available. Two months after the second biopsy, the patient returned for hemodialysis.
Kwon
Kye Weon
KW
Department of Pathology, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul 120-752, Korea.
Hong
Soon Won
SW
Kim
Soon Il
SI
Kim
Yu Seun
YS
Park
Ki Il
KI
Jeong
Hyeon Joo
HJ
D000328:Adult; D001485:Basement Membrane / Q000473:pathology*; D005922:Glomerulonephritis, IGA / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male