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

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 histoidentical 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.

journal_name

Nephron

journal_title

Nephron

authors

Trimarchi HM,Gonzalez JM,Truong LD,Brennan TS,Barrios R,Suki WN

doi

10.1159/000045412

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

270-3

issue

3

eissn

1660-8151

issn

2235-3186

pii

45412

journal_volume

82

pub_type

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