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A rare case of vascular rejection in a renal transplant recipient with nephrotic range proteinuria
Author(s) -
Akioka Kiyokazu,
Okamoto Masahiko,
Ushigome Hidetaka,
Nobori Shuji,
Kozaki Koichi,
Kaihara Satoshi,
Urasaki Koji,
Yanagisawa Akio,
Morozumi Kunio,
Yoshimura Norio
Publication year - 2007
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2007.00712.x
Subject(s) - medicine , proteinuria , nephrotic syndrome , creatinine , transplantation , immunosuppression , glomerulonephritis , gastroenterology , kidney transplantation , membranous nephropathy , urology , pathology , kidney
In the post‐cyclosporine A era, it has been reported that acute rejection after kidney transplantation is commonly revealed as an asymptomatic increase in the serum creatinine level. Nephrotic range proteinuria is observed in patients with recurrent or de novo glomerulonephritis, or with chronic transplant nephropathy and glomerulopathy in the late phase. Acute rejection occurring with nephrotic range proteinuria without a rise of serum creatinine has been rarely reported. Here, we report a rare case of vascular rejection in a renal transplant recipient with nephrotic range proteinuria. A 34‐yr‐old male renal transplant recipient presented with acute vascular rejection and early‐onset nephrotic syndrome. Severe nephrotic range proteinuria was detected with a minimally elevated level of serum creatinine. Biopsy showed severe glomerulitis and vasculitis, which was relieved by conversion of the immunosupressant regimen. Severe proteinuria was a sign of acute vascular rejection with severe glomerulitis and vasculitis. Careful observation to ensure maintenance of immunosuppression is necessary in such cases.