Recurrent and De novo Posttransplant Minimal Change Disease
- Incidence: This rarely recurs post kidney transplantation. Hence, recurrence risk factors and allograft prognosis is not known. De novo minimal change disease is also very rare.
- Clinical Features: Sudden onset nephrotic syndrome; need to rule out secondary causes such as malignancy, medications, and recurrent FSGS early in the post transplant period.
- Treatment: High dose steroids.
- Allograft Prognosis: The glomerular disease had no meaningful long term adverse effect on the on the kidney allograft when promptly treated.
Dr. Kenar Jhaveri
AJKD Blog Editor
To view the installment full-text or PDF (freely available), please visit the Atlas of Renal Pathology II at AJKD.org.
This is very nice figure and description.
A question that I have is how we can completely differentiate them from FSGS, since recurrent FSGS is more common, and when it recurs after kidney transplant, we can see foot process effacement in EM without FSGS lesion in light microscopy in early recurrence. This would raise also the possibility that primary disease prior to transplantation might be unsampled FSGS, instead of minimal change disease. Any biomarkers or genetic testings that we can use in this setting?