Pleomorphic presentations of IgA nephropathy - postrenal transplantation

Abstract

IgA nephropathy (IgAN) is a common cause of glomerulonephritis and end-stage renal disease. The recurrence of IgAN postrenal transplant is well documented. IgA recurrence posttransplant manifests as recurrent IgAN, de novo IgAN, and crescentic IgAN. Three cases are described in this article, representing the above-mentioned presentations of IgAN. The first case represents the manifestation of crescentic IgAN in a renal transplant recipient. The patient presented with severe graft dysfunction requiring hemodialysis. Inspite of aggressive immunosuppression and plasmapheresis, the graft kidney could not be salvaged. The second case represents recurrent IgAN. The patient was initiated on antiproteinuric measures and has maintained a stable graft function. The third case presented with de novo IgAN and acute antibody-mediated rejection (AMR). This patient was treated with immunosuppressants and plasmapheresis as per AMR treatment guidelines, following which his graft function improved.

Keywords

• Immunoglobulin A
• nephropathy
• plasmapheresis
• recurrence postrenal transplant