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10.1186/s12882-018-0969-3

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suck abstract from ncbi


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pmid29996809
      BMC+Nephrol 2018 ; 19 (1 ): 173
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  • Clinicopathological analysis of proliferative glomerulonephritis with monoclonal IgG deposits in 5 renal allografts #MMPMID29996809
  • Wen J ; Wang W ; Xu F ; Chen J ; Zhang M ; Cheng D ; Ni X ; Li X ; Liu Z
  • BMC Nephrol 2018[Jul]; 19 (1 ): 173 PMID29996809 show ga
  • BACKGROUND: We present a case series of 5 patients with proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) of renal allografts to better define its natural history, presenting characteristics, pathological features and treatment outcome. RESULTS: These 5 patients presented 5 to 19 months post-kidney transplantation for complaints of serum creatinine (Scr) elevation, proteinuria or hematuria. Membranoproliferative glomerulonephritis (MPGN) pattern was the most frequently observed histological manifestation. Immunofluorescence showed monoclonal IgG3?in 3 patients and IgG3? in the other 2 cases. Immunofluorescence staining helped to establish PGNMID in the absence of conspicuous microscopic changes in one case. Rituximab and bortezomib were effective in alleviating proteinuria in all 4 treated patients and decreasing Scr in 2 cases. Plasmapheresis treatment in another patient was not effective in preventing Scr elevation. At last-follow-up, 2 patients were in dialysis and 2 had improved kidney function with almost normal Scr and no proteinuria. The remaining one patient died of pulmonary infections. CONCLUSIONS: We conclude that PGNMID occurs early after kidney transplant. PGNMID should be included in the differential diagnoses of recurrent MPGN in renal allografts. Rituximab and bortezomib are helpful to decrease proteinuria and Scr in a subset of patients. Larger studies are needed to conclusively establish best treatment strategies for PGNMID in renal allografts.
  • |Adult [MESH]
  • |Allografts/*metabolism/pathology [MESH]
  • |Female [MESH]
  • |Follow-Up Studies [MESH]
  • |Glomerulonephritis, Membranoproliferative/diagnosis/*metabolism/*surgery [MESH]
  • |Humans [MESH]
  • |Immunoglobulin G/*metabolism [MESH]
  • |Kidney Transplantation/*adverse effects/trends [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Postoperative Complications/diagnosis/*metabolism [MESH]
  • |Retrospective Studies [MESH]


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