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A case of nephrotic syndrome 11 yr post‐kidney transplantation
Author(s) -
Nishi S.,
Imai N.,
Nakamura G.,
Ueno M.,
Kawamura K.,
Kaneko Y.,
Goto S.,
Alchi B.,
Saito K.,
Takahashi K.,
Gejyo F.
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.1399-0012.2007.00715.x
Subject(s) - medicine , mesangium , nephrotic syndrome , pathology , transplantation , glomerulopathy , kidney transplantation , glomerulonephritis , kidney , nephropathy , renal biopsy , biopsy , endocrinology , diabetes mellitus
We present here a male patient who had developed nephrotic syndrome 11 yr after kidney transplantation. Nephrotic syndrome suddenly occurred after severe sunburn he got in Hawaii. Such a clinical course seemed very rare in kidney transplantation, and multifactorial etiology was suspected. The histological findings of graft biopsy were intricate. On light microscopy, there were mesangial expansion and endocapillary proliferation with duplication of GBM and crescent formation. Deposits of IgM in mesangium were the most prominent finding on immunofluorescence microscopy, but IgA and C3 deposits were also detected. Electron microscopy revealed paramesangial and a few subepithelial dense deposits. Additionally, small organized deposits were found in the subepithelial space. Based on these findings, a provisional diagnosis of IgA nephropathy superimposed on chronic transplant glomerulopathy was made. However, hepatitis C virus related nephropathy could not be excluded.