De novo proteinuria with pathological evidence of glomerulonephritis after everolimus induction.
A 68-year-old man who underwent living-unrelated kidney transplantation from his spousal donor was immunosuppressed with tacrolimus and mycophenolate mofetil. Despite his uneventful clinical course, protocol biopsy at 2 years post transplant showed de novo CNI tubulotoxicity despite low tacrolimus exposure. Everolimus was added in order to discontinue TACER. However, prominent proteinuria impeded continuation of everolimus since biopsy showed diffuse glomerular endocapillary proliferation without C4d deposition. No donor-specific antibody was detected. Pulse steroids were given and proteinuria returned to normal with histological reversal.
Department of Urology and Renal Transplantation, Sapporo Hokuyu Hospital, Sapporo, Japan.
Masayoshi
M
Miura
Mitsuru
M
Yanai
Yuichiro
Y
Fukasawa
Hiroshi
H
Higashiyama
Yosuke
Y
Ito
Tohru
T
Tamaki
D000368:Aged; D000068338:Everolimus; D005921:Glomerulonephritis / Q000139:chemically induced* / Q000473:pathology; D006084:Graft Rejection / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D011507:Proteinuria / Q000139:chemically induced* / Q000473:pathology; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives*
D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus
everolimus; glomerulonephritis; kidney; proteinuria; transplantation