Recurrent Crescentic Membranous Nephropathy in Two Successive Renal Transplants: Association with Choroidal Effusions and Retinal Detachment

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Abstract

We report the case of a 50-year-old man in whom crescentic membranous nephropathy recurred in two succesive renal transplants leading rapidly to renal failure. Deterioration of renal function was associated with choroidal effusions and retinal detachments. Multiple serologic tests were negative. High-dose steroids, cyclophosphamide, cyclosporine, plasmapheresis and OKT3 failed to arrest the deterioration of renal function.

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Circulating factor associated with increased glomerular permeability to albumin in recurrent focal segmental glomerulosclerosis.

V Savin, R. Sharma, M. Sharma … (1996)

Heavy proteinuria and progressive renal injury recur after transplantation in up to 40 percent of patients with renal failure caused by idiopathic focal segmental glomerulosclerosis. A circulating factor may be responsible for this recurrence. To determine whether patients with focal segmental glomerulosclerosis have a circulating factor capable of causing glomerular injury, we tested serum samples from 100 patients with the disorder in an in vitro assay of glomerular permeability to albumin. Of the 56 patients who had undergone renal transplantation, 33 had recurrences. Sixty-four patients, many of whom had undergone transplantation, were being treated with dialysis. Thirty-one patients with other renal diseases and nine normal subjects were also studied. The 33 patients with recurrent focal segmental glomerulosclerosis after transplantation had a higher mean (+/-SE) value for permeability to albumin (0.47+/-0.06) than the normal subjects (0.06+/-0.07) or the patients who did not have recurrences (0.14+/-0.06). After plasmapheresis in six patients with recurrences, the permeability was reduced (from 0.79+/-0.06 to 0.10+/-0.05, P = 0.008), and proteinuria was significantly decreased. Patients with corticosteroid-sensitive nephrotic syndrome or with membranous nephropathy after transplantation had low levels of serum activity. The circulating factor bound to protein A and hydrophobic-interaction columns and had an apparent molecular mass of about 50 kd. A circulating factor found in some patients with focal segmental glomerulosclerosis is associated with recurrent disease after renal transplantation and may be responsible for initiating the renal injury.

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Membranous nephropathy with epithelial crescents in a patient with pulmonary sarcoidosis

T. TAYLOR, RT Taylor, HO Senekjian … (1979)

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Author and article information

Journal

Journal ID (publisher-id): AJN

Journal ID (nlm-ta): Am J Nephrol

Journal ID (doi): 10.1159/issn.0250-8095

Title: American Journal of Nephrology

Publisher: S. Karger AG

ISSN (Print): 0250-8095

ISSN (Electronic): 1421-9670

Publication date Subscription-year: 1998

Publication date (Print): April 1998

Publication date (Electronic): 01 April 1998

Volume: 18

Issue: 2

Pages: 146-150

Affiliations

Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, N.Y., USA

Article

Publisher ID: 13324 Other ID: Am J Nephrol 1998;18:146–150

DOI: 10.1159/000013324

PubMed ID: 9569958

SO-VID: 939d01ca-e9da-421c-be4c-9ad3664c67e2

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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Recurrent Crescentic Membranous Nephropathy in Two Successive Renal Transplants: Association with Choroidal Effusions and Retinal Detachment

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Abstract

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Karger: Nephrology

Most cited references 2

Circulating factor associated with increased glomerular permeability to albumin in recurrent focal segmental glomerulosclerosis.

Membranous nephropathy with epithelial crescents in a patient with pulmonary sarcoidosis

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