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Infection-related glomerulonephritis in a renal allograft
oleh: Natarajan Gopalakrishnan, Dhanapriya Jeyachandran, Padmanabha Abeesh, Thanigachalam Dineshkumar, Anila Abraham Kurien, Ramanathan Sakthirajan, T Balasubramaniyan
Format: | Article |
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Diterbitkan: | Wolters Kluwer Medknow Publications 2017-01-01 |
Deskripsi
Infection-related glomerulonephritis (IRGN) is an immune-mediated glomerulo-nephritis, most commonly caused by bacterial infections. Although there is an increased incidence of infectious episodes in renal transplant recipients, IRGN as a cause of de novo glomerulonephritis is rarely seen probably due to impaired immunity. We hereby report a 28-year-old male renal transplant recipient, who developed IRGN following impetigenous skin lesions after six years of transplant. He developed rapid worsening of allograft function and was started on hemodialysis. Allograft renal biopsy showed diffuse exudative endocapillary proliferation with crescents. Electron microscopy revealed large subepithelial hump-like deposits. Despite pulse steroid therapy, he became dialysis dependent. Our patient is unique in the way that poststreptococcal glomerulonephritis in an adult after renal transplantation has not been reported so far. We conclude that IRGN after renal transplant, though rare is a possible etiology for allograft dysfunction. There is no definitive treatment protocol for this de novo glomerulonephritis which has an overall poor prognosis.