Role of Nuclear Scan in a Patient With Recurrent Focal Segmental Glomerulosclerosis Post-Transplantation: A Case Report

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-09-01 DOI:10.1016/j.transproceed.2025.07.004

Sylvain Trincal , Diane Giovannini , Julie Roux , Hamza Naciri Bennani , Rémi Richaud , Thomas Jouve , Paolo Malvezzi , Lionel Rostaing

引用次数: 0

Abstract

A 35-year-old patient was diagnosed with biopsy-confirmed, steroid-and rituximab-resistant primary focal-segmental-glomerulosclerosis. While on hemodialysis, diuresis was maintained; proteinuria persisted at 9 g/g creatinine. He underwent kidney transplantation; 2-months post-transplantation, persistent proteinuria (3 g/g creatinine; albuminuria exceeding 50%) was observed. The serum creatinine level was 2.2 mg/dL. The kidney-transplant biopsy was normal. Technetium-99m-dimercaptosuccinic-acid (DMSA) renal scan revealed that native kidneys contributed to 30% of renal function. Irbesartan 150 mg/d/dapagliflozin 10 mg/d was started. Six months post-transplantation, proteinuria progressively increased to 7 to 8 g/g. We therefore decided to implement daily immunoadsorption sessions (11 sessions) followed by rituximab (1 infusion of 350 mg/m²). This allowed partial remission.

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核扫描在移植后复发局灶节段性肾小球硬化患者中的作用：1例报告。

一位35岁的患者被诊断为活检证实，类固醇和利妥昔单抗耐药原发性局灶-节段性肾小球硬化。在血液透析时，保持利尿；蛋白尿维持在9 g/g肌酐水平。他接受了肾移植；移植后2个月，持续性蛋白尿(3 g/g肌酐；蛋白尿超过50%)。血清肌酐水平为2.2 mg/dL。肾移植活检正常。锝-99m-二巯基琥珀酸（DMSA）肾脏扫描显示，天然肾脏占肾功能的30%。开始厄贝沙坦150mg /d/达格列净10mg /d。移植后6个月，蛋白尿逐渐增加至7 ~ 8 g/g。因此，我们决定实施每日免疫吸附疗程（11次），然后是利妥昔单抗（1次输注350mg /m²）。这允许部分缓解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.