Acute diffuse proliferative post‐infectious glomerulonephritis in renal allograft – A case report and literature review

Alsaad, Khaled O.; Aloudah, Nourah; AlHamdan, Hanouf M.; Alamir, Abdulrahman; Fakeeh, Khalid Al

doi:10.1111/petr.12233

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Moroni et al reported only three cases of IRGN in 827 renal transplantations performed between 1983 and 1992 [3]. In addition, only 11 cases of IRGN in allograft kidneys were reported in 2014 [4]. Except for streptococcal organisms, the etiology of these infections has been diverse in most cases [5][6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Some proportion of IRGN in adults has poor prognosis even after complete eradication of the causative infection, the detailed mechanism of which remains unclear [1,2]. IRGN in transplanted kidneys is extremely rare despite frequent opportunities for infection due to the immunosuppressed state; however, it is generally known to have a poor prognosis, the reasons for which are unknown [3][4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Chronological Changes in the Histology of Infection-Related Glomerulonephritis in Renal Allograft: A Case Report

Tominaga,

Oda,

Iwama

et al. 2024

IJMS

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We report the histological changes over time for a patient with infection-related glomerulonephritis (IRGN) that developed in a transplanted kidney. A 47-year-old man had undergone renal transplantation 3 years ago for end-stage kidney disease (ESKD). After several episodes of acute rejection, the patient was in a stable CKD condition. The abrupt development of severe microscopic hematuria and renal dysfunction was observed approximately 2 weeks after the onset of a phlegmon in his right leg. An allograft biopsy showed prominent glomerular endocapillary proliferation on light microscopy, granular C3 deposition on immunofluorescent microscopy, and subepithelial electron-dense deposits on electron microscopy, suggesting IRGN accompanied by moderate interstitial fibrosis and tubular atrophy (IFTA). Positive glomerular staining for nephritis-associated plasmin receptor (NAPlr) and plasmin activity, which are biomarkers of bacterial IRGN, supported the diagnosis. Although the infection was completely cured with antibiotic therapy, renal dysfunction persisted. A re-biopsy of the allograft 2 months later revealed resolution of the glomerular endocapillary proliferation and negative staining for NAPlr/plasmin activity, with worsening IFTA. We showed, for the first time, the chronological changes in infiltrating cells and histological markers of IRGN in transplanted kidneys. Glomerular changes, including NAPlr/plasmin activity staining, almost disappeared after the cessation of infection, while interstitial changes continuously progressed, contributing to ESKD progression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronological Changes in the Histology of Infection-Related Glomerulonephritis in Renal Allograft: A Case Report

Tominaga,

Oda,

Iwama

et al. 2024

IJMS

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“…In the latter, BKV was identified ultrastructurally in the immune deposits[ 302 ]. Glomerulonephritis attributed to BKV infection was found in a few renal transplant recipients[ 277 , 321 ].…”

Section: Part B Diagnosis Of Bkn and Pathogenesis Of Bkv Infection DImentioning

confidence: 99%

BK nephropathy in the native kidneys of patients with organ transplants: Clinical spectrum of BK infection

Vigil

Konstantinov

Barry

et al. 2016

WJT

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Nephropathy secondary to BK virus, a member of the Papoviridae family of viruses, has been recognized for some time as an important cause of allograft dysfunction in renal transplant recipients. In recent times, BK nephropathy (BKN) of the native kidneys has being increasingly recognized as a cause of chronic kidney disease in patients with solid organ transplants, bone marrow transplants and in patients with other clinical entities associated with immunosuppression. In such patients renal dysfunction is often attributed to other factors including nephrotoxicity of medications used to prevent rejection of the transplanted organs. Renal biopsy is required for the diagnosis of BKN. Quantitation of the BK viral load in blood and urine are surrogate diagnostic methods. The treatment of BKN is based on reduction of the immunosuppressive medications. Several compounds have shown antiviral activity, but have not consistently shown to have beneficial effects in BKN. In addition to BKN, BK viral infection can cause severe urinary bladder cystitis, ureteritis and urinary tract obstruction as well as manifestations in other organ systems including the central nervous system, the respiratory system, the gastrointestinal system and the hematopoietic system. BK viral infection has also been implicated in tumorigenesis. The spectrum of clinical manifestations from BK infection and infection from other members of the Papoviridae family is widening. Prevention and treatment of BK infection and infections from other Papovaviruses are subjects of intense research.

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“…Относительно новой чертой ОГН следует считать возможность его развития в качестве «второй» почечной болезни -на фоне предсуществующих хронических забо-леваний почек -IgA-нефропатии [33], диабетической не-фропатии [34,35], а также в почечном трансплантате [36]. В настоящее время ОПИГН, очевидно, играет возрастаю-щую роль в структуре причин хронической болезни почек в общей популяции, что обусловливает необходимость длительного наблюдения за этими больными даже в слу-чае, если констатировано клиническое выздоровление.…”

Section: на мухин и соавтunclassified

Acute glomerulonephritis in the 21st century

et al. 2015

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В настоящее время острый гломерулонефрит (ОГН) нечасто становится объектом крупных клинических ис-следований; это заболевание не относится к числу перво-очередных объектов для разработки алгоритмов диагно-стики и терапевтических вмешательств, а также эксперт-ных рекомендаций. Тем не менее на протяжении многих десятилетий, особенно до внедрения в клиническую практику антибиотиков широкого спектра действия, по-зволяющих быстро и эффективно воздействовать на стрептококковую инфекцию любой локализации, ОГН считался одной из наиболее актуальных проблем нефро-логии и в каждом нефрологическом стационаре почти всегда находилось несколько пациентов с этим заболева-нием. Стереотипное рассмотрение ОГН в группе других постстрептококковых заболеваний, означающее по суще-ству признание его клинико-эпидемиологического сход-ства с острой ревматической лихорадкой, стало причиной того, что, ожидая прогнозируемую вспышку этих «пост-стрептококковых» болезней в недалеком будущем, в на-стоящее время их считают казуистическими и, по суще-ству уже на первом этапе исключают из дифференциаль-но-диагностического плана. Вместе с тем ОГН, несмотря на общеизвестные четкость клинических проявлений и кажущуюся редкость хронизации болезни остается про-блемой, многие аспекты которой далеки от решения, и, более того, реальная ситуация нередко радикально отли- The paper discusses the specific features of the current course of acute glomerulonephritis, the spectrum of its etiological factors, and clinical manifestations. The factors influencing the course and outcomes of acute glomerulonephritis, including the risk of its progression to chronic kidney disease, are specially depicted.

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Acute diffuse proliferative post‐infectious glomerulonephritis in renal allograft – A case report and literature review

Cited by 5 publications

References 23 publications

Chronological Changes in the Histology of Infection-Related Glomerulonephritis in Renal Allograft: A Case Report

Chronological Changes in the Histology of Infection-Related Glomerulonephritis in Renal Allograft: A Case Report

BK nephropathy in the native kidneys of patients with organ transplants: Clinical spectrum of BK infection

Acute glomerulonephritis in the 21st century

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