title: Recurrent Proliferative Glomerulonephritis With Monoclonal IgG Deposits After a Renal Transplant Which Was Insensitive to Pulse Therapy Remitted by Double Filtration Plasmapheresis.
abstract: Proliferative glomerulonephritis with monoclonal IgG deposits manifesting as a nephrotic syndrome recently has been described as a renal disease with the pathological features of mesangial and subendothelial deposits of monoclonal IgG. Eight cases of recurrent proliferative glomerulonephritis with monoclonal IgG deposits after a renal transplant have been reported. Almost all of these patients had a certain remission of proteinuria by steroids alone or with cyclophosphamide, and had further remission through other special treatments (ie, rituximab and plasmapheresis). We present a case of recurrent proliferative glomerulonephritis with monoclonal IgG deposits of the IgG3? subtype after a renal transplant, which was insensitive to pulse intravenous methyl-prednisolone and cyclophosphamide remitted by double filtration plasmapheresis. This case report reveals that recurrent proliferative glomerulo-nephritis with monoclonal IgG deposits may be insensitive to intravenous pulse therapy of methylprednisolone and cyclophosphamide. We advocate double filtration plasmapheresis as an effective treatment of proliferative glomerulo-nephritis with monoclonal IgG deposits on remission of proteinuria.
authors.affiliation: National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Di
authors.initials: D
authors.lastname: Wu
authors.forename: Jin-Song
authors.initials: JS
authors.lastname: Chen
authors.forename: Dong-Rui
authors.initials: DR
authors.lastname: Cheng
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.forename: Xue
authors.initials: X
authors.lastname: Li
authors.forename: Shu-Ming
authors.initials: SM
authors.lastname: Ji
authors.forename: Ke-Nan
authors.initials: KN
authors.lastname: Xie
authors.forename: Xue-Feng
authors.initials: XF
authors.lastname: Ni
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Liu
authors.forename: Ji-Qiu
authors.initials: JQ
authors.lastname: Wen
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D015432:Glomerulonephritis, Membranoproliferative / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007668:Kidney / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D010956:Plasmapheresis / Q000379:methods*; D020551:Pulse Therapy, Drug; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone