Successful Treatment of Posttransplant Recurrent Complement C3 Glomerulopathy with Eculizumab

• Published in: Iranian 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
• Language: English
• 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
• ISSN: 1735-8582

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.