Open AccessPrimary focal segmental glomerulosclerosis recurring rapidly as collapsing glomerulopathy in a renal allograft recipient
Author(s) -
Vinita Agrawal,
Narayan Prasad,
Priyankar Singh
Publication year - 2017
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.206465
Subject(s) - medicine , focal segmental glomerulosclerosis , proteinuria , renal biopsy , minimal change disease , biopsy , transplantation , glomerulopathy , kidney transplantation , kidney disease , urology , end stage renal disease , pathology , kidney , disease
Recurrent focal segmental glomerulosclerosis (FSGS) develops in about 30%-40% of patients of FSGS undergoing renal transplantation. We report a patient who received a live- related renal transplant for end-stage renal disease due to a primary FSGS (not otherwise specified) in the native kidney and presented with graft dysfunction in the immediate posttransplant period. The first and the second biopsy showed no evidence of rejection or glomerular lesion. A repeat biopsy done on the 30th day revealed recurrent FSGS morphologically presenting as collapsing variant. The patient was found to have massive proteinuria. Electron microscopy done retrospectively showed glomerular foot process effacement even in the first biopsy. This case highlights the presence of an early minimal change disease-like phase in recurrent FSGS and the necessity of evaluation for proteinuria even in immediate and early posttransplant period. It also shows that different variants of FSGS may represent a spectrum of the same disease and suggests a likely role of a pathogenic circulating factor even in collapsing FSGS requiring further evaluation.