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Insidious transmission of membranous nephropathy from kidney donor with no clinical manifestations before and after transplantation
Author(s) -
Horike Keiji,
Takeda Asami,
Kitamura Ken,
Ogiyama Keiko,
Sakai Kaoru,
Onoda Hiroshi,
Goto Norihiko,
Sato Tetsuhiko,
Nagasaka Takaharu,
Uchida Kazuharu,
Morozumi Kunio
Publication year - 2008
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.1399-0012.2008.00855.x
Subject(s) - medicine , urinalysis , subclinical infection , kidney , renal function , kidney transplantation , nephropathy , biopsy , transplantation , proteinuria , renal biopsy , kidney disease , pathology , urology , urinary system , endocrinology , diabetes mellitus
Abstract: Live kidney donors are supposed to have no clinical kidney disease. Here, we present a unique case of subclinical membranous nephropathy (MN) from a living donor, who had urinalysis‐free stable kidney function pre‐ and post‐transplant. A 39‐yr‐old Asian woman received a second kidney graft from her spouse whose urinalysis and blood chemistry were stable and normal. Her intraoperative one‐h core biopsy revealed thick glomerular basement membrane (GBM) and a bubbly type appearance, compatible with stage II MN on Churg’s classification. According to two other protocol biopsies, GBM thickening persisted until month six post‐transplant. Interestingly, both the donor and the recipient had stable kidney function without overt proteinuria at each monthly visit until one yr post‐transplant. Taken together, we speculate that “silent” MN may exist in certain healthy individuals, who present only with histopathologically compatible MN and no other findings.