title: Histologic recurrence of Henoch-Schonlein Purpura nephropathy after renal transplantation on routine allograft biopsy.
abstract: BACKGROUND
  Henoch-Schonlein Purpura nephropathy (HSPN) recurrence in renal transplant recipients (RTRs) has been reported in 35% of patients, leading in 11% of these patients to graft loss at 5 years. However, its true incidence is unknown. The aim of this study was to investigate this recurrence incidence using routine allograft biopsies (RBs).
  
  
  METHODS
  All RTRs with biopsy-proven HSP initial nephropathy were included (13 RTRs and 18 renal transplantations). At transplantation, the median age was 34 years, and 85% of RTRs were men. Overall, we analyzed 66 RBs that were routinely performed at 3 and 12 months after RT and when clinically indicated. Histologic recurrence was defined as the presence of IgA deposits within the mesangium and along the glomerular capillary walls.
  
  
  RESULTS
  After a median follow-up of 83 months (range, 13-232 months; interquartile range, 26-235 months), histologic recurrence was detected in 69% of patients and in 61% of grafts after a mean period of 24 months (range, 1-156 months). Clinical or biological signs were absent in all but one. Patient survival was 92.8%. Graft loss occurred in five cases, never were related to recurrence. At the last follow-up, the mean glomerular filtration rate was 48±14.2 mL/min/1.73 m(2); in patients with and without recurrence, the mean rates were 52.1±17.5 and 42.4±5.3 mL/min/1.73 m(2), respectively (P=0.27).
  
  
  CONCLUSIONS
  Histologic recurrence of HSPN after RT is frequently observed on routine RBs but is not associated with clinical consequences. The short-term prognosis of recurrence is good, but its long-term prognosis remains to be determined.
authors.affiliation: Universite Paris Descartes, Paris, France. eric.thervet@egp.aphp.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Thervet
authors.forename: Jessie
authors.initials: J
authors.lastname: Aouizerate
authors.forename: Laure Helene
authors.initials: LH
authors.lastname: Noel
authors.forename: Isabelle
authors.initials: I
authors.lastname: Brocheriou
authors.forename: Frank
authors.initials: F
authors.lastname: Martinez
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Mamzer
authors.forename: Christophe
authors.initials: C
authors.lastname: Legendre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000209:etiology*; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D051437:Renal Insufficiency / Q000209:etiology*; D012307:Risk Factors; D014184:Transplantation, Homologous