Abstract
A case of aggressive lupus nephritis in a pediatric renal transplant patient is described. She initially presented with end-stage glomerulonephritis for which an underlying etiology could not be determined. Ten months after cadaveric renal transplantation, systemic lupus erythematosus was diagnosed, when she developed diffuse proliferative glomerulonephritis in association with antinuclear antibody, anti-double-stranded DNA antibody and extrarenal manifestations of lupus. It is plausible that she developed recurrent rather thande novo lupus nephritis following transplantation. Reactivation of lupus nephritis in a renal transplant is unusual in adults, and is previously unreported in children.
References
Cheigh JS, Kim H, Stenzel KH, Tapia L, Sullivan JF, Stubenbord W, Riggio RR, Rubin AL (1990) Systemic lupus erythematosus in patients with end-stage renal disease; long term follow-up on the prognosis of patients and the evolution of lupus activity. Am J Kidney Dis 16:189–195
Coplon NS, Diskin CJ, Petersen J, Swensen RS (1983) The long-term clinical course of systemic lupus erythematosus in end-stage renal disease. N Engl J Med 308:186–190
Mejia G, Zimmerman SW, Glass NR, Miller DT, Sollinger HW, Belzer FO (1983) Renal transplantation in patients with systemic lupus erythematosus. Arch Intern Med 143:2089–2092
Bumgardner GL, Mauer SM, Payne W, Dunn DL, Sutherland DER, Fryd DS, Ascher NL, Simmons RL, Najarian JS (1988) Single center 1–15 year results of renal transplantation in patients with systemic lupus erythematosus. Transplant 46:703–709
Nossent HC, Swaak TJG, Berden JHM, Dutch Working Party on Systemic Lupus Erythematosus (1991) Systemic lupus erythematosus after renal transplantation: patient and graft survival and disease activity. Ann Intern Med 114:183–186
Mathew TH (1988) Recurrence of disease following renal transplantation. Am J Kidney Dis 12:85–96
Cameron JS (1989) The treatment of lupus nephritis. Pediatr Nephrol 3:350–362
Nossent HC, Swaak TJG, Berden JHM, Dutch Working Party on Systemic Lupus Erythematosus (1990) Systemic lupus erythematosus: analysis of disease activity in 55 patients with end-stage renal failure treated with hemodialysis or continuous ambulatory peritoneal dialysis. Am J Med 89:169–174
Kumano K, Sakai T, Mashimo S, Endo T, Koshiba K, Elises JS, Iitaka K (1987) A case of recurrent lupus nephritis after renal transplantation. Clin Nephrol 27:94–98
Amend WJC, Vincenti F, Feduska NJ, Salvatierra O, Johnston WH, Jackson J, Tilney N, Garovoy M, Burwell EL (1981) Recurrent systemic lupus erythematosus involving renal allografts. Ann Intern Med 94:444–448
Yakub YN, Freeman RB, Pabico RC (1981) Renal transplantation in systemic lupus erythematosus. Nephron 27:197–201
Sohmiya S, Morozumi K, Yoshida A, Niimura I, Takeda A, Oikawa S, Fujinami T, Kanoh T, Uchida K, Yamada N, Tominaga Y, Kawai M, Gotoh I, Nakamura S, Ohkura T, Takagi H (1986) A case of recurrent lupus nephritis after transplantation immunosuppressed with cyclosporine A. Jpn J Transplant 21:18–23
Moorthy AV, Zimmermann SW, Mejia G, Sollinger HW, Belzer FO (1987) Recurrence of lupus nephritis after renal transplantation. Kidney Int 31:464
Roth D, Milgrom M, Esquenazi V, Strauss J, Zilleruelo G, Miller J (1987) Renal transplantation in systemic lupus erythematosus: one center's experience. Am J Nephrol 7:367–374
Fernandez JA, Milgrom M, Burke GW, Miller J, Roth D (1990) Recurrence of lupus nephritis in a renal allograft with histologic transformation of the lesion. Transplant 50:1056–1058
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Fox, L., Zager, P.G., Harford, A.M. et al. Lupus nephritis in a pediatric renal transplant recipient. Pediatr Nephrol 6, 467–469 (1992). https://doi.org/10.1007/BF00874017
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DOI: https://doi.org/10.1007/BF00874017