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Membranous Lupus Nephritis in a Renal Allograft: Response to Mycophenolate Mofetil Therapy
Author(s) -
Denton Mark D.,
Galvanek Eleonora G.,
Singh Ajay,
Sayegh Mohamed H.
Publication year - 2001
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1034/j.1600-6143.2001.001003288.x
Subject(s) - medicine , lupus nephritis , proteinuria , mycophenolate , renal biopsy , systemic lupus erythematosus , immunology , gastroenterology , transplantation , renal function , kidney , disease
Membranous lupus nephritis in a renal allograft is considered rare. A 43‐year‐old man with quiescent systemic lupus erythematosus (SLE) received a HLA identical transplant from his sister and 4 years later developed persistent nephrotic range proteinuria and morphological features most compatible with membranous lupus nephritis on biopsy. Angiotensin‐converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists, although successful in reducing proteinuria, were associated on three occasions with acute allograft dysfunction. Sustained reduction of proteinuria and stable graft function were achieved using mycophenolate mofetil (MMF). MMF is emerging as a new therapy for primary renal disease in SLE. This is the first report of successful treatment of membranous lupus nephritis in an allograft using MMF. We review all cases of transplant‐associated membranous lupus nephritis in the English literature.