Conflict of interests: None.
In search of an effective treatment for recurrent mesangiocapillary glomerulonephritis in the renal allograft
Article first published online: 14 MAR 2014
© 2014 Asian Pacific Society of Nephrology
Special Issue: Renal Transplant Case Series 2013. Guest Editor: Peter Kerr. Publication of this supplement has been supported through an independent educational grant from Novartis Australia
Volume 19, Issue Supplement S1, pages 6–9, April 2014
How to Cite
Cai, M. M., Simpson, I. and Mulley, W. R. (2014), In search of an effective treatment for recurrent mesangiocapillary glomerulonephritis in the renal allograft. Nephrology, 19: 6–9. doi: 10.1111/nep.12191
- Issue published online: 14 MAR 2014
- Article first published online: 14 MAR 2014
- Accepted manuscript online: 27 JAN 2014 05:56AM EST
- Manuscript Accepted: 18 DEC 2013
- renal transplantation;
In patients with end-stage kidney disease (ESKD) secondary to mesangiocapillary glomerulonephritis (MCGN), recurrent disease post transplantation is a common cause of graft loss. We report a case of a 33-year-old female with ESKD due to idiopathic MCGN who developed recurrent disease in two consecutive renal allografts. Recurrent disease was diagnosed two months after receiving her primary transplant from a live related donor. Oral cyclophosphamide was initiated but discontinued after 10 months due to cystitis. This was followed by rapid deterioration in her renal function. Despite salvage therapy with rituximab, the graft was lost 2 years post transplantation. After 7 years on haemodialysis, the patient received a second graft from a deceased donor. Recurrent MCGN was once again diagnosed one year post transplantation. She was treated with plasma exchange and rituximab. Despite ongoing nephrotic range proteinuria, her graft function remained stable 2 years post transplantation. The optimal therapy for recurrent MCGN is unknown at this stage. It is hoped that a better understanding of its pathogenesis will enable the development of more effective and targeted therapies.