An unusual recurrence of crescentic nephritis after renal transplantation for IgA nephropathy.
The recurrence of immunoglobulin A nephropathy (IgAN) after renal transplantation has been described in 40% to 50% of cases. For a long time, this type of recurrence was considered as a benign condition. However, recent data have shown that recurrent IgAN has become a significant cause of long-term allograft loss. The authors present here the case of a 47-year-old man with IgAN, which led to end-stage renal failure in 1999. In November 2000, he received a cadaveric renal allograft. Ten months later, acute nephritic syndrome and rapidly progressive renal failure developed. Renal biopsy showed extracapillary glomerulonephritis with crescent formation in one third of the glomeruli associated with necrosis. Steroid treatment was unsuccessful, and renal function progressively deteriorated with a creatinine level at 3.7 mg/dL 6 months after diagnosis of recurrence. This patient's graft probably will be lost in a few months.
Benabdallah
Leila
L
Department of Renal Transplantation, Necker Hospital, Paris, France.
Rerolle
Jean-Philippe
JP
Peraldi
Marie-Noelle
MN
Noël
Laure-Hèléne
LH
Bruneel
Marie-France Mamzer
MF
Carron
Pierre-Louis
PL
Morelon
Emmanuel
E
Kreis
Henri
H
D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005922:Glomerulonephritis, IGA / Q000601:surgery*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D051437:Renal Insufficiency / Q000188:drug therapy / Q000209:etiology
D007166:Immunosuppressive Agents; D011239:Prednisolone; D009173:Mycophenolic Acid; D001379:Azathioprine