{"title":"Nephrotic proteinuria and hematuria with newly diagnosed IgA nephropathy after liver transplant: A case report","authors":"Tingli Wang , Honghong Ren , Dan Yin , Hongyu Qiu","doi":"10.1016/j.trim.2024.102003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>IgA nephropathy is a renal lesion in patients with end-stage liver disease, called hepatic IgA nephropathy. The common manifestation of hepatic IgA nephropathy is microscopic hematuria. Sirolimus, often used to prevent organ rejection, has been reported to induce proteinuria after organ transplantation. But few cases of nephrotic proteinuria and hematuria are reported.</p></div><div><h3>Case presentation</h3><p>In this case, a 45-year-old male with a long history of hepatic B virus infection and liver cirrhosis, received liver transplant and was taking sirolimus as one of his immunosuppression drugs. Overt proteinuria and hematuria occurred. With no proteinuria history before, renal biopsy was performed, which indicated IgA nephropathy.</p></div><div><h3>Conclusion</h3><p>We reported a liver recipient, who was taking sirolimus, developing nephrotic proteinuria and hematuria with IgA nephropathy. Further studies need to be carried out to disclose mechanism behind this phenomenon.</p></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant immunology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966327424000194","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
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Abstract
Background
IgA nephropathy is a renal lesion in patients with end-stage liver disease, called hepatic IgA nephropathy. The common manifestation of hepatic IgA nephropathy is microscopic hematuria. Sirolimus, often used to prevent organ rejection, has been reported to induce proteinuria after organ transplantation. But few cases of nephrotic proteinuria and hematuria are reported.
Case presentation
In this case, a 45-year-old male with a long history of hepatic B virus infection and liver cirrhosis, received liver transplant and was taking sirolimus as one of his immunosuppression drugs. Overt proteinuria and hematuria occurred. With no proteinuria history before, renal biopsy was performed, which indicated IgA nephropathy.
Conclusion
We reported a liver recipient, who was taking sirolimus, developing nephrotic proteinuria and hematuria with IgA nephropathy. Further studies need to be carried out to disclose mechanism behind this phenomenon.
背景:IgA 肾病是终末期肝病患者的一种肾脏病变,称为肝性 IgA 肾病。肝IgA肾病的常见表现是镜下血尿。西罗莫司常用于预防器官排斥反应,有报道称其会在器官移植后诱发蛋白尿。但很少有肾病性蛋白尿和血尿的病例报道:在本病例中,一名 45 岁的男性接受了肝移植手术,并服用了西罗莫司作为免疫抑制剂之一,他有长期的肝 B 病毒感染和肝硬化病史。他出现了明显的蛋白尿和血尿。由于之前没有蛋白尿病史,他接受了肾活检,结果显示为 IgA 肾病:我们报告了一名服用西罗莫司的肝脏受者出现肾病性蛋白尿和血尿,并伴有IgA肾病。这一现象背后的机制还需要进一步研究。
期刊介绍:
Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.