Focal segmental glomerulosclerosis in a 32-year-old kidney allograft after 7 years without immunosuppression

Hernan M. Trimarchi, Juan M. Gonzalez, Luan Truong, T. Stephen Brennan, Roberto Barrios, Wadi N. Suki

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

In kidney allografts, focal segmental glomerulosclerosis (FSGS) has been described as recurrent, de novo, or a histological variant of chronic transplant glomerulopathy. We describe a unique case of de novo FSGS in a renal transplant not accompanied by any feature of rejection in a patient who had not been immunosuppressed for several years. A 58-year-old woman received a histo-identical living-related kidney transplant for end-stage renal disease due to chronic pyelonephritis. Twenty-four years after the transplant she voluntarily discontinued all immunosuppressive medication. Seven years later she presented with nephrotic syndrome, mild renal failure, and positive serology for hepatitis C virus (HCV) antibody. The kidney transplant biopsy disclosed de novo FSGS. Features of acute or chronic rejection, including chronic transplant glomerulopathy, were not seen. The pathogenesis of this lesion is probably related to sustained and prolonged glomerular hyperfiltration; alternatively, HCV infection may have triggered or accelerated the appearance of FSGS.

Original languageEnglish (US)
Pages (from-to)270-273
Number of pages4
JournalNephron
Volume82
Issue number3
DOIs
StatePublished - Jul 14 1999

Keywords

  • Focal segmental glomerulosclerosis, de novo
  • Immunosuppression
  • Renal transplant

ASJC Scopus subject areas

  • Nephrology

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