Lupus Nephritis Can Recur 12 Years After Transplant

According to a story from Renal and Neurology News, a recent study has revealed that lupus nephritis, a rare kidney disease associated with lupus, can suddenly recur even years after the patient has undergone a kidney transplant. This is possible even without the normal indicators of a lupus flareup. A study presented at this year’s National Kidney Foundation Spring Clinical Meetings described the unique case involving a 39 year old woman.

About Lupus Nephritis

Lupus nephritis is a medical complication characterized by kidney inflammation which can appear as a result of systemic lupus erythematosus, more commonly known as lupus. In effect it is a form of glomerulonephritis, but this form is linked specifically to lupus and has notable differences in outcomes and presentation. Lupus nephritis is an autoimmune disease in which the body’s own immune system mistakenly attacks healthy tissue. The cause of lupus and lupus nephritis is not well understood, with a variety of genetic and environmental factors possibly playing a role. Symptoms of the disease include swelling, fever, foamy urine, joint pain, high blood pressure, muscle pain, and the characteristic butterfly rash that also appears with systemic lupus. Treatment usually involves the use of immune system suppressing drugs such as corticosteroids, but when the disease progresses to kidney failure, kidney transplant is the best option. To learn more about lupus nephritis, click here.

Case Study

This patient developed kidney failure in 2006 which was subsequently treated with a transplant in February of 2007. Before the procedure, a biopsy revealed global sclerosis and immune complex glomerulonephritis that was linked to the presence of anticardiolipin and positive serum antinuclear antibodies. Following the operation, the patient continued to receive immunosuppressive therapy in the form of prednisone, mycophenolate mofetil, and tacrolimus.

In the years following, her doctors noted an increase in serum creatinine, but this eventually stabilized at around 1.4-1.6 mg/dL. Many years later, in July 2019, her creatinine suddenly climbed to 3.9 mg/dL. She also had microscopic hematuria and proteinuria. By November of that year, she was on dialysis after a biopsy indicated focally crescentic lupus nephritis, thrombotic microangiopathy, and diffuse proliferative glomerulonephritis. Treatment with steroids and cyclophosphamide was not able to prevent kidney failure.

The case revealed the need for further research to understand how lupus nephritis can suddenly appear so many years later following years of stable kidney function.

Learn more about this study here.

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