Successful Treatment of Posttransplant Recurrent Complement C3 Glomerulopathy with Eculizumab

Two-thirds of complement C3 glomerulopathy (C3G) recur after transplantation and commonly cause graft loss. There is not a standard treatment protocol for these cases. We present a kidney transplant patient with recurrent C3G who was successfully treated with eculizumab. Nephrotic proteinuria and he...

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Published inIranian journal of kidney diseases Vol. 12; no. 5; p. 315
Main Authors Sahin, Hatice, Gok Oguz, Ebru, Akoglu, Hadim, Atilgan, Gokhan, Ulusal Okyay, Gulay, Karaveli Gursoy, Guner, Kip Teymur, Tugba, Ertoy, Dilek, Canbakan, Basol, Ayli, Mehmet Deniz
Format Journal Article
LanguageEnglish
Published Iran Iranian Society of Nephrology 01.09.2018
Subjects
Antibodies, Monoclonal, Humanized - administration & dosage
Complement C3 - metabolism
Creatinine - blood
Glomerulonephritis - blood
Glomerulonephritis - drug therapy
Hematuria - etiology
Humans
Kidney Glomerulus - pathology
Kidney Transplantation - adverse effects
Male
Middle Aged
Monoclonal antibodies
Proteinuria - etiology
Recurrence
Transplants & implants
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Summary:Two-thirds of complement C3 glomerulopathy (C3G) recur after transplantation and commonly cause graft loss. There is not a standard treatment protocol for these cases. We present a kidney transplant patient with recurrent C3G who was successfully treated with eculizumab. Nephrotic proteinuria and hematuria occurred and creatinine levels increased after transplantation. A graft biopsy revealed recurrent C3G. The patient was administered 250 mg pulse methylprednisolone for 3 days and had 9 sessions of plasmapheresis. Since elevated creatinine levels and proteinuria persisted, eculizumab was instituted. A complete remission was observed after 9-month maintenance eculizumab treatment. Eculizumab may be a potentially effective option in kidney transplant patients with recurrent C3G unresponsive to other treatment modalities.
ISSN:1735-8582
1735-8604