title: Successful anti-TNFalpha treatment in a child with posttransplant recurrent focal segmental glomerulosclerosis.
abstract: Posttransplant recurrence of focal and segmental glomulosclerosis (FSGS) occurs in approximately 30% of patients, and remains after uncontrolled despite increased immunosuppression and plasma exchanges (PE) in approximately 30% of cases. New immunosuppressive drugs might then be warranted. We report the case of a 15-year-old boy with FSGS leading to end-stage renal disease (ESRD) who presented with an early posttransplant recurrence of disease. Reinforced immunosuppression and PE resulted in partial and transient disease control, but proteinuria significantly decreased with anti-TNFalpha treatment (infliximab then etanercep). This is the first case report of successful anti-TNFalpha treatment despite a constant high activity of FSGS, as demonstrated by relapse after discontinuation of anti-TNFalpha agents.
authors.affiliation: Department of Pediatric Nephrology, Armand-Trousseau Hospital, AP-HP & University, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Leroy
authors.forename: V
authors.initials: V
authors.lastname: Guigonis
authors.forename: D
authors.initials: D
authors.lastname: Bruckner
authors.forename: V
authors.initials: V
authors.lastname: Emal-Aglae
authors.forename: G
authors.initials: G
authors.lastname: Deschênes
authors.forename: A
authors.initials: A
authors.lastname: Bensman
authors.forename: T
authors.initials: T
authors.lastname: Ulinski