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De novo and recurrent post-transplant membranous nephropathy cases show similar rates of concurrent antibody-mediated rejection.
Khorsandi, Nikka; Han, Hwarang Stephen; Rajalingam, Raja; Shoji, Jun; Urisman, Anatoly.
Afiliación
  • Khorsandi N; Department of Pathology, University of California, San Francisco, San Francisco, CA, United States.
  • Han HS; Department of Medicine, Nephrology Division, University of California, San Francisco, San Francisco, CA, United States.
  • Rajalingam R; Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, TX, United States.
  • Shoji J; Immunogenetics and Transplantation Laboratory, Department of Surgery, University of California, San Francisco, San Francisco, CA, United States.
  • Urisman A; Department of Medicine, Nephrology Division, University of California, San Francisco, San Francisco, CA, United States.
Front Nephrol ; 4: 1438065, 2024.
Article en En | MEDLINE | ID: mdl-39290350
ABSTRACT

Background:

Membranous nephropathy (MN) can develop post-kidney transplant and is classified as a recurrent disease in patients with a history of MN in the native kidneys or as de novo disease in patients without such history. The mechanism of recurrent MN is thought to be like that of primary MN, but the mechanism of de novo MN is not well delineated. An association between de novo MN and antibody-mediated rejection (AMR) has been suggested.

Methods:

A search of the pathology database from our medical center identified 11 cases of recurrent and 15 cases of de novo MN, in which clinical and histologic findings were compared. No significant differences were identified in the demographic characteristics, serum creatinine and proteinuria trends, or rates of allograft failure between the recurrent and de novo MN groups.

Results:

Rates of concurrent AMR were high in both groups (36% and 40%, respectively) but not statistically different from each other. PLA2R immunofluorescence (IF) positivity was seen in 64% of recurrent MN cases compared to 33% of de novo MN cases, suggesting a higher incidence of PLA2R-positive de novo MN than previously reported. No significant histologic differences were identified in the initial biopsies from the two groups, except mean IgG intensity by IF was higher in the recurrent group, suggesting a higher load of immune complex deposits at diagnosis in this group.

Conclusion:

The findings do not provide support for a specific association between AMR and de novo MN, but whether there is a possible link between both forms of post-transplant MN and AMR remains an unanswered question.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Nephrol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Nephrol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza