| The Pathology and Clinical Features of Early Recurrent Membranous Glomerulonephritis. | |
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MedLine Citation:
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PMID: 22233329 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We assessed the earliest manifestations of recurrent membranous glomerulonephritis (MGN) in renal allografts. Clinical, laboratory and pathologic data were reviewed in 21 patients at the initial biopsy within 4 months post-transplant with evidence of MGN and on follow-up biopsies, compared to a biopsy control group of eight transplants without recurrent MGN. The mean time of first biopsy with pathologic changes was 2.7 months. In each earliest biopsy, immunofluorescence (IF) showed granular glomerular basement membrane (GBM) staining for C4d, IgG, kappa and lambda. IF for C3 was negative or showed trace staining in 16/21. On each MGN biopsy positive by IF, 14/19 showed absence of deposits or rare tiny subepithelial deposits by electron microscopy (EM). At the earliest biopsy, the mean proteinuria was 1.1 g/day; 16 patients had <1 g/day proteinuria. Follow-up was available in all patients (mean 35 months posttransplant). A total of 13 patients developed >1 g/day proteinuria; 12 were treated with: rituximab (n = 8), ACEI and increased prednisone dose (n = 2), ACEI or ARB only (n = 2). All patients showed reduction in proteinuria after treatment. A total of 11/16 patients showed progression of disease by EM on follow-up biopsy. Recognition of early allograft biopsy features aids in diagnosis of recurrent MGN before patients develop significant proteinuria. |
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Authors:
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E F Rodriguez; F G Cosio; S H Nasr; S Sethi; M E Fidler; M D Stegall; J P Grande; F C Fervenza; L D Cornell |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-10 |
Journal Detail:
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Title: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons Volume: - ISSN: 1600-6143 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100968638 Medline TA: Am J Transplant Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons. |
Affiliation:
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Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN Department of Medicine, Mayo Clinic, Rochester, MN Department of Surgery, Mayo Clinic, Rochester, MN. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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