Postinfectious Acute Glomerulonephritis in Renal Transplantation: An Emergent Aetiology of Renal Allograft Loss

Despite the high incidence of posttransplant infections, postinfectious acute glomerulonephritis (PIAGN) in renal allograft is a rare entity, without effective treatment and a bad prognosis. We describe two cases of PIAGN: the first one was developed 2 years after kidney transplantation, secondary t...

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Published inCase reports in transplantation Vol. 2019; no. 2019; pp. 1 - 4
Main Authors Diekmann, Fritz, Poch, Esteban, Quintana, Luis F., Solé, Manel, Cofan, Frederic, Revuelta, Ignacio, De Sousa-Amorim, Erika, Aguiar, Pedro, Cucchiari, David, Montagud-Marrahí, Enrique, Molina-Andújar, Alícia, García-Herrera, Adriana
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 2019
Hindawi
John Wiley & Sons, Inc
Hindawi Limited
Wiley
Subjects
Alcoholism
Biopsy
Care and treatment
Case Report
Case reports
Cloxacillin
Corticosteroids
Diabetes
Glomerulonephritis
Health aspects
Hemodialysis
Immunoglobulin A
Infection
Infections
Kidneys
Methylprednisolone
Nephrology
Pathology
Staphylococcus aureus infections
Transplantation
Transplants & implants
Urinalysis
United States > US
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Summary:Despite the high incidence of posttransplant infections, postinfectious acute glomerulonephritis (PIAGN) in renal allograft is a rare entity, without effective treatment and a bad prognosis. We describe two cases of PIAGN: the first one was developed 2 years after kidney transplantation, secondary to Staphylococcus aureus bacteremia with presence of extracapillary proliferation in biopsy. The patient was treated with methylprednisolone and plasma exchanges without response, remaining dialysis dependent. The second case was reported 5 years after kidney transplantation, secondary to influenza A infection. Kidney biopsy showed an IgA-dominant PIAGN and methylprednisolone boluses were initiated without clinical response, suffering a progressive worsening and loss of kidney graft. Due to the aggressive clinical course of this entity, PIAGN should be considered in the differential diagnosis of acute kidney graft failure in the context of an infection. Elderly patients have a higher risk of more severe acute renal dysfunction, requiring dialysis in a great proportion of cases.
Bibliography:Academic Editor: Marian Klinger
ISSN:2090-6943
2090-6951
DOI:10.1155/2019/7438254