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10.1186/s12882-018-0858-9

http://scihub22266oqcxt.onion/10.1186/s12882-018-0858-9
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suck abstract from ncbi


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pmid29540152
      BMC+Nephrol 2018 ; 19 (1 ): 64
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  • Successful treatment of recurrent immunoglobulin a nephropathy using steroid pulse therapy plus tonsillectomy 10 years after kidney transplantation: a case presentation #MMPMID29540152
  • Katsumata H ; Yamamoto I ; Komatsuzaki Y ; Kawabe M ; Okabayashi Y ; Yamakawa T ; Katsuma A ; Nakada Y ; Kobayashi A ; Tanno Y ; Miki J ; Yamada H ; Ohkido I ; Tsuboi N ; Yamamoto H ; Yokoo T
  • BMC Nephrol 2018[Mar]; 19 (1 ): 64 PMID29540152 show ga
  • BACKGROUND: Both prevention and treatment of recurrent immunoglobulin A nephropathy (IgAN) in kidney transplant recipients are important since recurrent IgAN seems to affect long-term graft survival. We present here a case of recurrent IgAN that was successfully treated using steroid pulse therapy plus tonsillectomy 10 years after kidney transplantation. CASE PRESENTATION: A 46-year-old male was admitted for an episode biopsy with a serum creatinine level of 1.8 mg/dl and proteinuria (0.7 g/day). Histological features showed recurrent IgAN (only focal segmental mesangial proliferation) and severe arteriolar hyalinosis partly associated with calcineurin inhibitor toxicity, with limited interstitial fibrosis and tubular atrophy (5%) (IF/TA) 8 years after transplantation. Sodium restriction and conversion from cyclosporine to tacrolimus successfully reduced his proteinuria to the level of 0.15 g/day. However, 2 years later, his proteinuria increased again (1.0 g/day) and a second episode biopsy showed global mesangial proliferation with glomerular endocapillary and extracapillary proliferation accompanied by progressive IF/TA (20%). The steroid pulse therapy plus tonsillectomy successfully decreased his proteinuria and he achieved clinical remission 3 years after this treatment. CONCLUSION: This case, presented with a review of relevant literature, demonstrates the difficulty and importance of the treatment of recurrent IgAN and calcineurin inhibitor arteriolopathy, especially in long-term kidney allograft management.
  • |*Tonsillectomy [MESH]
  • |Combined Modality Therapy/methods [MESH]
  • |Glomerulonephritis, IGA/diagnosis/*drug therapy/*surgery [MESH]
  • |Humans [MESH]
  • |Kidney Transplantation/*trends [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Pulse Therapy, Drug [MESH]
  • |Recurrence [MESH]
  • |Steroids/*administration & dosage [MESH]
  • |Time Factors [MESH]


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