Successful anti-TNFalpha treatment in a child with posttransplant recurrent focal segmental glomerulosclerosis.
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.
Leroy
S
S
Department of Pediatric Nephrology, Armand-Trousseau Hospital, AP-HP & University, Paris, France.
Guigonis
V
V
Bruckner
D
D
Emal-Aglae
V
V
Deschênes
G
G
Bensman
A
A
Ulinski
T
T