Recurrent or De Novo IgA Nephropathy with Crescent Formation after Renal Transplantation

Tang, Zheng; Ji, Song; Chen, Dong-Rui; Wen, Jie; Chen, Jinsong; Liu, Fei; Leishi, LI

doi:10.1080/08860220802134516

Cited by 36 publications

(32 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Retrospective analysis of the initial renal biopsy failed to demonstrate renal damages compatible with IgA nephropathy. The occurrence of IgA nephropathy after renal transplantation is much rarer than the classical recurrence of IgA nephropathy on graft, but it can happen exceptionally as described in two series [15, 16]. …”

Section: Discussionmentioning

confidence: 99%

Successful Outcome of a Corticodependent Henoch-Schönlein Purpura Adult with Rituximab

Sala

Michot

Snanoudj

et al. 2014

Case Reports in Medicine

View full text Add to dashboard Cite

Henoch-Schönlein purpura (HSP) is a systemic vasculitis involving small vessels with deposition of immunoglobulin A (IgA) complexes, usually affecting children. Compared with children, HSP in adults is more severe and frequently associated with cancer. We report the case of a 49-year-old woman with medical history of kidney transplantation for segmental glomerular hyalinosis. Eight years after the transplantation, while taking combined immunosuppressive therapy with tacrolimus and azathioprine indicated for the prevention against transplant rejection, she developed a Henoch-Schönlein purpura. Vasculitis involves skin and sciatic peroneal nerve and she received systemic corticosteroid treatment. Because of four relapses and corticosteroid dependence, the patient was treated with rituximab (two intravenous infusions of 1000 mg given two weeks apart). Successful outcome was observed along two years of follow-up. This new case of successful use of rituximab in HSP promotes more investigations of this treatment in clinical trials.

show abstract

Section: Discussionmentioning

confidence: 99%

Successful Outcome of a Corticodependent Henoch-Schönlein Purpura Adult with Rituximab

Sala

Michot

Snanoudj

et al. 2014

Case Reports in Medicine

View full text Add to dashboard Cite

show abstract

“…However, these results should be interpreted with caution because several details are lacking in retrospective reviews of registry data. Most other pretransplant characteristics are not consistently predictive for recurrence, although some authors have suggested that latent IgA deposits in the donor kidney (in "zero" time biopsies of the transplanted kidney) are highly associated with a recurrence of disease (27), and underlying crescentic GN with rapid progression to ESRD may also predict a higher risk for recurrence (28). There is now general agreement that the type and intensity of posttransplant immunosuppression does not influence the risk of IgAN recurrence.…”

Section: Iganmentioning

confidence: 92%

Posttransplant Recurrence of Primary Glomerulonephritis

Ponticelli

Glassock

2010

Clinical Journal of the American Society of Nephrology

213

166

View full text Add to dashboard Cite

All forms of primary GN may recur after kidney transplantation and potentially jeopardize the survival of the graft. IgA nephritis (IgAN) may recur in approximately one third of patients, more frequently in younger patients and in those with a rapid progression of the original disease. However, with the exception of few patients with rapid progression, there is no evidence that recurrence of IgAN has a deleterious effect on graft survival at least up to 10 years. Recurrence of focal segmental glomerulosclerosis (FSGS) is often associated with nephrotic proteinuria and is more frequent in children, in patients with rapid progression of the original disease, and in those who lost a previous transplant from recurrence. The natural course of recurrent FSGS is usually unfavorable. Early and intensive plasmapheresis may obtain complete or partial response in several patients. Good results have also been reported with rituximab. Idiopathic membranous nephropathy (IMN) may recur in 30% to 40% of patients. The graft survival in patients with IMN is not different than that of patients with other renal diseases. Good results with rituximab have been reported. Membranoproliferative GN (MPGN) may recur in 27% to 65% of patients. The recurrence is more frequent and the prognosis is more severe in type II MPGN. Although recurrent GN is relatively frequent and may worsen the outcome of renal allografts in some patients, its effect is diluted by several other risk-factors that may have a greater effect than recurrent GN on the long-term graft survival.

show abstract

“…An aggressive form of the original disease with crescents at initial biopsy and a rapid progression to ESRD may predict a higher rate of recurrence (11)(12)(13). In our five patients with recurrence, crescents were present in the biopsy of the native kidney in only one patient, whereas the time between diagnosis of HSPN and ESRD was shorter in patients with disease recurrence than in patients without recurrence (4 years [1 to 6 years] versus 6 years [3 to 11 years]) but not reaching statistical significance.…”

Section: Discussionmentioning

confidence: 99%

Recurrence and Graft Loss after Kidney Transplantation for Henoch–Schönlein Purpura Nephritis

Kanaan

Mourad²,

Thervet³

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives The actuarial risk at 5 years for clinical recurrence of Henoch-Schö nlein purpura nephritis (HSPN) and graft loss caused by recurrence of -HSPN after renal transplantation was reported in 1994 to be as high as 35% and 11%, respectively. The aim of this study is to re-evaluate, in a large cohort of patients with a long-term follow-up, whether these rates have changed. Design, setting, participants, & measurementsPatients from six transplant centers in Belgium and France with strict diagnostic criteria of HSPN and a potential post transplant follow-up of Ն3 years were included.Results Forty-three patients were included. Patient survival is excellent: 98%, 95%, and 95% at 5, 10, and 15 years, respectively. Overall graft survival rates were 84%, 66%, and 56% at 5, 10, and 15 years, respectively. Clinical recurrence in a first kidney transplant occurred in five patients. Three patients lost their first graft due to HSPN recurrence 19 to 96 months after transplantation, two of whom had systemic signs of the illness. Actuarial risk for clinical recurrence in a first graft is 2.5% and 11.5% at 5 and 10 years, respectively. Actuarial risk for graft loss caused by recurrence in a first graft is 2.5% and 7.5% at 5 and 10 years, respectively. Severity of the disease at presentation and type of immunosuppression after transplantation did not affect recurrence. ConclusionsWe found that recurrence rates of HSPN after transplantation are lower than previously reported. The actuarial risk of graft loss from recurrence in a first graft is 7.5% at 10 years.

show abstract

Recurrent or De Novo IgA Nephropathy with Crescent Formation after Renal Transplantation

Cited by 36 publications

References 14 publications

Successful Outcome of a Corticodependent Henoch-Schönlein Purpura Adult with Rituximab

Successful Outcome of a Corticodependent Henoch-Schönlein Purpura Adult with Rituximab

Posttransplant Recurrence of Primary Glomerulonephritis

Recurrence and Graft Loss after Kidney Transplantation for Henoch–Schönlein Purpura Nephritis

Contact Info

Product

Resources

About