Premium
Disappearance of Tophi in Familial Juvenile Hyperuricemic Nephropathy after Kidney Transplantation
Author(s) -
Merieau E.,
Al Najjar A.,
Halimi J.M.,
Sacquépée M.,
Nivet H.,
Lebranchu Y.,
Büchler* M.
Publication year - 2007
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 - 10.1111/j.1600-6143.2007.01977.x
Subject(s) - medicine , juvenile , kidney transplantation , transplantation , nephropathy , genetics , endocrinology , biology , diabetes mellitus
A 40‐year‐old man who had been on hemodialysis for 25 months due to familial juvenile hyperuricemic nephropathy (FJHN) received a kidney transplant. Biopsy of his native kidney had shown tubulo‐interstitial nephropathy. Genetic analysis confirmed abnormal uromodulin expression due to a mutation in the exon 4 of the UMOD gene. He had multiple tophi on the day of transplantation, including some on his fingers. He received immunosuppressive treatment including polyclonal antilymphocyte antibodies, mycophenolate mofetil, steroids and cyclosporine and achieved excellent renal function, with serum creatinine at 13 mg/L on day 10 posttransplantation and 9.4 mg/L at 6 months. His uric acid excretion rate increased from 4.4% at day 2 posttransplantation to 7.7% 6 months after transplantation. The number and sizes of the tophi were reduced 3 months posttransplantation, and nearly disappeared at month 6. Serum uric acid level decreased slowly from 650 μmol/L before transplantation to 300 μmol/L. Reduction of tophi was probably due to the absence of the mutated UMOD gene in the transplanted kidney.