title: Immunoglobulin A Nephropathy in a Living Kidney Donor Diagnosed and Treated After Transplantation: A Case Report.
abstract: OBJECTIVE
  We report the clinical course and pathologic findings of a kidney transplant donor who was diagnosed with immunoglobulin A (IgA) nephropathy by means of preimplantation biopsy and was later treated with methylprednisolone and tonsillectomy.
  
  
  METHODS
  The patient was a 57-year-old woman who met the criteria for kidney donation and was accepted as a donor. Donor nephrectomy was performed, and the preimplantation biopsy revealed that the donor had IgA nephropathy. One month after the nephrectomy, the donor's laboratory findings indicated proteinuria and hematuria. Because these findings indicated active IgA nephropathy, we decided to perform tonsillectomy and methylprednisolone pulse therapy. Soon after these treatments, the patient's proteinuria and hematuria were no longer observed.
  
  
  CONCLUSIONS
  Subclinical IgA nephropathy can be incidentally found on preimplantation biopsies of living kidney donors. As demonstrated in this case, IgA nephropathy can become exacerbated and requires therapeutic intervention after kidney donation. Informed consent and careful observation should be used before and after transplantation, even for donors who have been determined to be eligible for kidney donation.
authors.affiliation: Department of Nephrology, Ohkubo Hospital, Tokyo, Japan. Electronic address: momoko_kouno@tokyo-hmt.jp.
authors.forename: M
authors.initials: M
authors.lastname: Kono
authors.affiliation: Department of Nephrology, Ohkubo Hospital, Tokyo, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Hasegawa
authors.affiliation: Department of Nephrology, Ohkubo Hospital, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ogawa
authors.affiliation: Department of Nephrology, Ohkubo Hospital, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Endo
authors.affiliation: Department of Nephrology, Ohkubo Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Wakai
authors.affiliation: Department of Urology, Ohkubo Hospital, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Shirakawa
authors.affiliation: Department of Pathology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Honda
mesh_terms: D046148:Donor Selection; D005260:Female; D005922:Glomerulonephritis, IGA / Q000175:diagnosis* / Q000628:therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D006417:Hematuria / Q000209:etiology / Q000628:therapy; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009392:Nephrectomy; D011507:Proteinuria / Q000209:etiology / Q000628:therapy; D014068:Tonsillectomy
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone