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Focal segmental glomerular sclerosis recurrence with massive proteinuria and anuria immediately after kidney transplantation
Author(s) -
Maruyama Michihiro,
Kitamura Hiroshi,
Akutsu Naotake,
Otsuki Kazunori,
Hasegawa Masayuki,
Aoyama Hiromichi,
Matsumoto Ikuko,
Saigo Kenichi,
Asano Takehide
Publication year - 2015
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12455
Subject(s) - medicine , anuria , plasmapheresis , biopsy , urology , proteinuria , transplantation , kidney transplantation , renal biopsy , renal function , surgery , kidney , pathology , antibody , immunology
Here, we report a case of focal segmental glomerular sclerosis ( FSGS ) recurrence immediately (47 minutes) after transplantation. A 1‐hour biopsy specimen showed large periodic acid‐Schiff–positive granules within the cells of the swollen proximal tubule, while electron microscopy revealed podocyte swelling and partial foot process effacement. These findings were worse on day 2 biopsy. Massive proteinuria and anuria were then observed. Two courses (2 × 2 times) of plasmapheresis and rituximab were administered, and the graft function gradually recovered. A day 22 biopsy specimen showed improvement in findings compared to those observed on day 2. One year after transplantation, no signs of FSGS recurrence are evident, and graft function remains good.