Universität zu Köln

Voelker, Linus A., Burkert, Katharina, Scholten, Niklas, Grundmann, Franziska, Kurschat, Christine, Benzing, Thomas, Hampl, Juergen, Becker, Jan Ulrich ORCID: 0000-0003-2929-8085 and Mueller, Roman-Ulrich (2019). A case report of recurrent membranoproliferative glomerulonephritis after kidney transplantation due to ventriculoatrial shunt infection. BMC Nephrol., 20 (1). LONDON: BMC. ISSN 1471-2369

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Abstract

Background Transplant failure requires the consideration of numerous potential causes including rejection, acute tubular necrosis, infection, and recurrence of the original kidney disease. Kidney biopsy is generally required to approach these differential diagnoses. However, the histopathological findings on their own do not always lead to a definite diagnosis. Consequently, it is crucial to integrate them with clinical findings and patient history when discussing histopathological patterns of injury. The histopathologic finding of a membranoproliferative glomerulonephritis (MPGN) is one of the most challenging constellations since it does not refer to a specific disease entity but rather reflects a pattern of injury that is the result of many different causes. Whilst MPGN is occasionally classified as immune complex mediated, careful evaluation usually reveals an underlying disorder such as chronic infection, plasma cell dyscrasia, complement disorders, and autoimmune disease. Case presentation We describe the case of a 43-year-old woman who was referred to us because of a slowly rising serum creatinine 4 years after kidney transplantation. As in the native kidney, the biopsy revealed an MPGN pattern of injury. The cause of this finding had not been established prior to transplantation leading to a classification as idiopathic MPGN in the past. Further workup at the time of presentation and allograft failure revealed chronic infection of a ventriculoatrial shunt as the most probable cause. Conclusion This case underlines the fact that MPGN is not a disease but a histopathological description. Consequently, the causative disorder needs to be identified to avoid kidney failure and recurrence after transplantation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Voelker, Linus A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burkert, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Scholten, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Grundmann, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Kurschat, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Benzing, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hampl, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Jan Ulrich UNSPECIFIED orcid.org/0000-0003-2929-8085 UNSPECIFIED Mueller, Roman-Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-144805
DOI:	10.1186/s12882-019-1472-1
Journal or Publication Title:	BMC Nephrol.
Volume:	20
Number:	1
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2369
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROPIONIBACTERIUM-ACNES; NEPHRITIS; IMMUNOGLOBULIN; COMPLEMENT; ANTIGEN Multiple languages Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14480