CASE REPORT


A Case of Anti-Glomerular Basement Membrane Crescentic Glomerulonephritis in a Female Renal Allograft Recipient with Unknown Native Disease: Retrospective Molecular Confirmation of Alport Disease



Mahesha Vankalakunti1, *, Ashish Parekh2, Anil K. B. Thimmegowda3, Rajanna Sreedhara2
1 Manipal Hospitals, Bangalore, India
2 Fortis Hospitals, Bangalore, India
3 BGS Gleneagles Global Hospitals, Bangalore, India


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Creative Commons License
© 2019 Mahesha Vankalakunti.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Pathology & Laboratory Medicine #98, Rustom Bagh, HAL Airport Road, Bangalore, INDIA – 560017;
Tel: +91-80-25023564; Fax: +91-80-25254563; Email: vkmahes123@gmail.com


Abstract

Anti-Glomerular Basement Membrane (anti-GBM) crescentic glomerulonephritis developing in an allograft is a rare phenomenon. A patient with Alport syndrome receiving a renal transplant is at risk of developing anti-GBM glomerulonephritis, due to the absence of normal COL4α3, COL4α4 and COL4α5 trimer of the collagen network. Two unique challenges with planning kidney transplant in such a patient include- ideal donor selection; and risk of developing anti-GBM nephritis. We report a case of post-transplant anti-GBM crescentic glomerulonephritis in a female recipient with unknown native kidney disease who was diagnosed with Alport disease when she presented with hematuria and proteinuria nearly 2 years postrenal transplant. Allograft outcome in our case was unfavourable, patient reaching end-stage kidney disease within 6-month of diagnosis. The patient remains on continuous ambulatory peritoneal dialysis and currently active on the deceased donor transplant waiting list.

Keywords: Alport syndrome, Anti-GBM crescentic glomerulonephritis, Renal transplantation, Proteinuria, Glomerulonephritis, peritoneal dialysis.