Recurrence of fibrillary glomerulonephritis in a renal transplant recipient

Fibrillary glomerulonephritis (FGN) is a rare glomerular deposition disease and a rare cause of nephrotic syndrome. The patients usually present with renal insufficiency, nephrotic range proteinuria and microscopic hematuria. The electron microscopy study is the only means of diagnosis. The clinical...

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Bibliographic Details
Published in:International urology and nephrology 2013-10, Vol.45 (5), p.1527-1532, Article 1527
Main Authors: Mitwalli, Ahmed, Shah, Iqbal, Hammad, Durdana, Kafoury, Hala
Format: Article
Language:English
Subjects:
Glomerulonephritis - complications
Glomerulonephritis - pathology
Humans
Kidney Failure, Chronic - etiology
Kidney Failure, Chronic - surgery
Kidney Glomerulus - ultrastructure
Kidney Transplantation
Male
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Nephrology - Case Report
Recurrence
Urology
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Summary:Fibrillary glomerulonephritis (FGN) is a rare glomerular deposition disease and a rare cause of nephrotic syndrome. The patients usually present with renal insufficiency, nephrotic range proteinuria and microscopic hematuria. The electron microscopy study is the only means of diagnosis. The clinical course of the disease is generally unpredictive and the patients inevitably progress to ESRD. Here, we describe a case of FGN, which presented with nephrotic syndrome and impaired renal function. Renal biopsy showed that 26 out of 30 glomeruli were completely sclerosed. Remaining showed mesangial expansion and double contour consistent with a membranoproliferative pattern, with 70 % interstitial fibrosis and tubular atrophy. Immunofluorescence revealed C3 (2+) diffuse mesangial deposits. Electron microscopic showed subendothelial dense deposits with organized tubular structures. During follow-up, the patient underwent renal transplantation from a living unrelated kidney donor. Later on, as the renal allograft function showed deterioration, renal biopsy was performed and showed recurrence of FGN in the renal allograft.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-012-0238-5