26.03.2024 | Lessons for the Clinical Nephrologist
Class V lupus nephritis recurrence with histologic resolution in a kidney transplant recipient on a pregnancy-adapted immunosuppression protocol: a lesson for the clinical nephrologist
verfasst von:
Jorane-Tiana Robert, Ajay Rajaram, Pierre O. Fiset, Chantal Bernard, Ratna Samanta, Shaifali Sandal
Erschienen in:
Journal of Nephrology
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Excerpt
A kidney transplant recipient of Cambodian ethnicity was diagnosed with systemic lupus erythematosus in her teens. She had initially reported cutaneous and musculoskeletal manifestations and was diagnosed with class IV lupus nephritis (LN) at the age of 18 years. She was treated with cyclophosphamide and steroids complicated by avascular hip necrosis and recurrent urinary infections. She developed kidney failure, and in 2008 at the age of 23 years, she received a living-related kidney transplant, followed by an uneventful post-operative course. She had a 5/6 HLA mismatch with her donor. Baseline creatinine was 50-60 micromol/L and she had mild to moderate albuminuria (20–40 mg/mmol). Maintenance immunosuppression included prednisone 5 mg daily, mycophenolate mofetil 1g twice a day and tacrolimus targeted to a trough of 4-8 ng/mL. She developed hypertension and dyslipidemia, but lupus remained quiescent. …
