STEPHEN W. ZIMMERMAN, M.D.; LAWRENCE R. HYMAN, M.D.; DAVID T. UEHLING, M.D.; PETER M. BURKHOLDER, M.D.
Two children with renal allografts developed membranoproliferative glomerulonephritis that was histopathologically similar to their original disease. Recurrent disease was diagnosed in biopsy specimens from one child with a cadaveric graft, at 2 and at 5½ years after transplantation. The graft remains functional at 6 years, although persistent hematuria, proteinuria, and mild renal failure are evident. The second child received a D-match kidney from her brother. Two years later recurrent glomerulonephritis and chronic graft rejection necessitated a transplant nephrectomy. Immunofluorescence microscopy of renal allografts from both patients showed glomerular deposition of C3 and properdin, with minimal or no deposition of complement-fixing immunoglobulins. Glomerular deposits of properdin factor B (C3 proactivator) were also seen in one of the children. These findings suggest that membranoproliferative glomerulonephritis may recur in renal allografts, possibly through activation of the alternate complement pathway.
ZIMMERMAN SW, HYMAN LR, UEHLING DT, BURKHOLDER PM. Recurrent Membranoproliferative Glomerulonephritis with Glomerular Properdin Deposition in Allografts. Ann Intern Med. ;80:169–175. doi: 10.7326/0003-4819-80-2-169
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Published: Ann Intern Med. 1974;80(2):169-175.
Autoimmune Kidney Disease, Nephrology, Rheumatology.
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