Recurrent membranoproliferative glomerulonephritis after second renal graft treated with plasmapheresis and rituximab.
Transplant Proc
; 43(10): 4005-9, 2011 Dec.
Article
in En
| MEDLINE
| ID: mdl-22172889
ABSTRACT
We present a case of a 45-year-old man who suffered from idiopatic membranoproliferative glomerulonephritis (MPGN) in the native kidney that relapsed after his first and second renal grafts. The patient was diagnosed in 1990 with lobular MPGN type I, receiving his first renal graft in 1996. In 2001, a biopsy showed recurrence of MPGN type I (rMPGN). He underwent a second renal graft in 2008. In January 2010, he experienced increased proteinuria and creatinine. Upon electron microscopy of a renal graft biopsy we diagnosed a new rMPGN. At the time of the biopsy, complement levels were normal, although C3 and C4 decreased further. We administered 12 plasmapheresis (PP) sessions and four doses of rituximab. Due to persistent renal impairment, we performed a new biopsy 3 months later, showing less severity of the acute lessions. He received a new cycle of treatment (PP+rituximab). One year later, his renal function was stable with a creatinine ranging between 2 and 2.5 mg/dL and a protein/creatinine ratio less than 1 mg/mg. We concluded that the treatment stopped the disease progression.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Glomerulonephritis, Membranoproliferative
/
Kidney Transplantation
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Plasmapheresis
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Antibodies, Monoclonal, Murine-Derived
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Immunologic Factors
Limits:
Humans
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Male
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Middle aged
Language:
En
Journal:
Transplant Proc
Year:
2011
Document type:
Article
Affiliation country:
Spain
Publication country:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
/
UNITED STATES
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UNITED STATES OF AMERICA
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US
/
USA