Case report: Early onset de novo FSGS in a child after kidney transplantation-a successful treatment
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Case report: Early onset de novo FSGS in a child after kidney transplantation-a successful treatment. / Carvajal Abreu, Karla; Loos, Sebastian; Fischer, Lutz; Pape, Lars; Wiech, Thorsten; Kemper, Markus J; Tönshoff, Burkhard; Oh, Jun; Schild, Raphael.
in: FRONT PEDIATR, Jahrgang 11, 1280521, 26.09.2023.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › Case Report › Forschung › Begutachtung
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T1 - Case report: Early onset de novo FSGS in a child after kidney transplantation-a successful treatment
AU - Carvajal Abreu, Karla
AU - Loos, Sebastian
AU - Fischer, Lutz
AU - Pape, Lars
AU - Wiech, Thorsten
AU - Kemper, Markus J
AU - Tönshoff, Burkhard
AU - Oh, Jun
AU - Schild, Raphael
N1 - © 2023 Carvajal Abreu, Loos, Fischer, Pape, Wiech, Kemper, Tönshoff, Oh and Schild.
PY - 2023/9/26
Y1 - 2023/9/26
N2 - BACKGROUND: Early onset de novo focal segmental glomerular sclerosis (FSGS) in the kidney allograft in patients without FSGS in the native kidney is a rare disorder in children. It usually occurs mostly beyond the first year after kidney transplantation and often leads to graft loss. Standardized treatment protocols have not yet been established.CASE DESCRIPTION: We describe a boy with early onset de novo FSGS in the transplanted kidney and non-selective glomerular proteinuria (maximum albumin-to-creatinine ratio of 3.8 g/g; normal range, ≤0.03 g/g creatinine). Manifestation occurred at 30 days posttransplant and was accompanied by a significant graft dysfunction (eGFR 61 ml/min per 1.73 m2). Treatment with 25 sessions of plasmapheresis over 14 weeks and three consecutive days of methylprednisolone pulse therapy (10 mg/kg per day) followed by oral prednisolone as rejection prophylaxis (3.73 mg/m2 per day) led to sustained remission of proteinuria (albumin-to-creatinine ratio of 0.028 g/g) and normalization of graft function (eGFR 92 ml/min per 1.73 m2) after 14 weeks. The follow-up period was 36 months.CONCLUSIONS: This case underlines the efficacy of immunosuppressive and antibody eliminating therapy in early onset de novo FSGS after kidney transplantation.
AB - BACKGROUND: Early onset de novo focal segmental glomerular sclerosis (FSGS) in the kidney allograft in patients without FSGS in the native kidney is a rare disorder in children. It usually occurs mostly beyond the first year after kidney transplantation and often leads to graft loss. Standardized treatment protocols have not yet been established.CASE DESCRIPTION: We describe a boy with early onset de novo FSGS in the transplanted kidney and non-selective glomerular proteinuria (maximum albumin-to-creatinine ratio of 3.8 g/g; normal range, ≤0.03 g/g creatinine). Manifestation occurred at 30 days posttransplant and was accompanied by a significant graft dysfunction (eGFR 61 ml/min per 1.73 m2). Treatment with 25 sessions of plasmapheresis over 14 weeks and three consecutive days of methylprednisolone pulse therapy (10 mg/kg per day) followed by oral prednisolone as rejection prophylaxis (3.73 mg/m2 per day) led to sustained remission of proteinuria (albumin-to-creatinine ratio of 0.028 g/g) and normalization of graft function (eGFR 92 ml/min per 1.73 m2) after 14 weeks. The follow-up period was 36 months.CONCLUSIONS: This case underlines the efficacy of immunosuppressive and antibody eliminating therapy in early onset de novo FSGS after kidney transplantation.
U2 - 10.3389/fped.2023.1280521
DO - 10.3389/fped.2023.1280521
M3 - Case report
C2 - 37830056
VL - 11
JO - FRONT PEDIATR
JF - FRONT PEDIATR
SN - 2296-2360
M1 - 1280521
ER -
