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- Title
De novo minimal change disease associated with reversible post-transplant nephrotic syndrome. A report of five cases and review of literature.
- Authors
Zafarmand, Alireza A; Baranowska-Daca, Elzbieta; Ly, Peter DC; Tsao, Chun C; Choi, Yeong-Jin; Suki, Wadi N; Truong, Luan D
- Abstract
Zafarmand AA, Baranowska-Daca E, Ly PDC, Tsao CC, Choi Y-J, Suki WN, Truong LD. De novo minimal change disease associated with reversible post-transplant nephrotic syndrome. A report of five cases and review of literature. Clin Transplant 2002: 16: 350–361. © Blackwell Munksgaard, 2002 Nephrotic syndrome (NS) is frequent in renal transplant recipients and may be related to a large variety of glomerular lesions. In some of these cases, the transplant biopsy showed no significant glomerular changes and the NS was reversible, but the primary renal disease was not minimal change disease (MCD), suggesting that MCD may develop de novo in renal transplant setting. Knowledge of this entity, however, is limited. Among 67 cases of post-transplant NS encountered in a 12-yr period, five were found to be associated with de novo MCD. A critical review of the literature revealed nine additional cases of de novo MCD. The data from these 14 cases show that patients with de novo MCD had a large variety of primary renal diseases but MCD or focal segmental glomerulosclerosis was not among them. Eight of the 14 transplanted kidneys (60%) were from living related donors, suggesting this as a risk factor. Nephrotic range proteinuria (3–76 g/d) developed immediately or shortly after transplantation (within 4 months for all reported cases, except for one at 24 months). The serum creatinine when NS was first diagnosed was normal or mildly elevated, but acute renal failure occurred in three patients. On biopsy, the glomeruli were normal or, more frequently, displayed mild, focal segmental mesangial sclerosis, hypercellularity, deposition of IgM/C3, or accumulation of mononuclear inflammatory cells in some glomerular capillaries. The tubulointerstitial compartment was normal in cases with normal renal function; displayed mild acute and/or chronic rejection that correlated with a mildly elevated serum creatinine; or showed acute changes including acute rejection, acute...
- Subjects
NEPHROTIC syndrome; TRANSPLANTATION of organs, tissues, etc.
- Publication
Clinical Transplantation, 2002, Vol 16, Issue 5, p350
- ISSN
0902-0063
- Publication type
Article
- DOI
10.1034/j.1399-0012.2002.02023.x