BACKGROUND AND OBJECTIVES: Glomerular lesions in allografts in recipients with end-stage nephritis resulting from systemic lupus erythematosus (SLE) were examined to determine the spectrum of glomerular pathology in recurrent glomerulonephritis (GN). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 156 biopsy samples, from 49 serial allografts in 43 recipients with end-stage lupus nephritis, were examined by light microscopy, and by immunofluorescence and electron microscopy in selected cases. These were compared with control allografts (n = 35). RESULTS: Glomerular lesions best explained by recurrent lupus nephritis were observed in 19 of 49 allografts (38.8%) in lupus recipients. Three categories of glomerulopathies were identified: 1) immune complex glomerulopathies, including mesangial GN (28%) and membranous GN (4%); 2) atypical glomerulopathies, including acute proliferative GN (32%) and focal segmental glomerulosclerosis (12%), with scant immune deposits in glomerular capillaries, frequent endothelial tubuloreticular inclusions, and thrombotic microangiopathy; and 3) transplant-associated glomerulopathies (24%). CONCLUSIONS: Allografts from recipients with SLE had typical immune complex-mediated GN and atypical pauci-immune, proliferative GN and segmental glomerular sclerosis. Atypical glomerulopathies like these suggest a role for nonimmune complex-mediated glomerular injury in recurrent lupus GN.
BACKGROUND AND OBJECTIVES:Glomerular lesions in allografts in recipients with end-stage nephritis resulting from systemic lupus erythematosus (SLE) were examined to determine the spectrum of glomerular pathology in recurrent glomerulonephritis (GN). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 156 biopsy samples, from 49 serial allografts in 43 recipients with end-stage lupus nephritis, were examined by light microscopy, and by immunofluorescence and electron microscopy in selected cases. These were compared with control allografts (n = 35). RESULTS:Glomerular lesions best explained by recurrent lupus nephritis were observed in 19 of 49 allografts (38.8%) in lupus recipients. Three categories of glomerulopathies were identified: 1) immune complex glomerulopathies, including mesangial GN (28%) and membranous GN (4%); 2) atypical glomerulopathies, including acute proliferative GN (32%) and focal segmental glomerulosclerosis (12%), with scant immune deposits in glomerular capillaries, frequent endothelial tubuloreticular inclusions, and thrombotic microangiopathy; and 3) transplant-associated glomerulopathies (24%). CONCLUSIONS: Allografts from recipients with SLE had typical immune complex-mediated GN and atypical pauci-immune, proliferative GN and segmental glomerular sclerosis. Atypical glomerulopathies like these suggest a role for nonimmune complex-mediated glomerular injury in recurrent lupus GN.
Authors: Eric Daugas; Dominique Nochy; Du Le Thi Huong; Pierre Duhaut; Hélène Beaufils; Valérie Caudwell; Jean Bariety; Jean-Charles Piette; Gary Hill Journal: J Am Soc Nephrol Date: 2002-01 Impact factor: 10.121
Authors: Simin Goral; Christina Ynares; Scott B Shappell; Shannon Snyder; Irene D Feurer; Rumeyza Kazancioglu; Agnes B Fogo; J Harold Helderman Journal: Transplantation Date: 2003-03-15 Impact factor: 4.939
Authors: L C Racusen; K Solez; R B Colvin; S M Bonsib; M C Castro; T Cavallo; B P Croker; A J Demetris; C B Drachenberg; A B Fogo; P Furness; L W Gaber; I W Gibson; D Glotz; J C Goldberg; J Grande; P F Halloran; H E Hansen; B Hartley; P J Hayry; C M Hill; E O Hoffman; L G Hunsicker; A S Lindblad; Y Yamaguchi Journal: Kidney Int Date: 1999-02 Impact factor: 10.612
Authors: Michelle Willicombe; Jill Moss; Linda Moran; Paul Brookes; Eva Santos-Nunez; Adam G McLean; Thomas Cairns; David Taube; Terence H Cook; Candice Roufosse Journal: J Am Soc Nephrol Date: 2015-11-27 Impact factor: 10.121
Authors: Cinthia B Drachenberg; John C Papadimitriou; Preeti Chandra; Abdolreza Haririan; Susan Mendley; Matthew R Weir; Mario F Rubin Journal: Kidney Int Rep Date: 2019-07-30