Pre- and Posttransplant Glomerulonephritis in a Case of Sarcoidosis

Abstract

A 39-year-old woman with documented sarcoidosis and membranous glomerulonephritis (GN) with renal failure received a kidney from her identical twin. A few months after transplantation a proliferative GN appeared with hematuria, proteinuria and progressive renal failure over 2 years. Indeed the occurrence of GN in patients with sarcoidosis raises the question of whether the relationship between these two conditions is causal or fortuitous. This report suggests that GN is secondary to sarcoidosis.

Glomerulonephritis in sarcoidosis: causal relationship unproven

“…'33' In one patient crescentic proliferative glomerulonephritis recurred following transplantation. 24 Several authors (D.G. James, unpublished observations cited in References 22 and 24) have noted that the relative infrequency of glomerulonephritis as a manifestation of sarcoid causes uncertainty as to whether the coincidence of the two conditions is fortuitous or causally related.…”

Tumour necrosis factor-alpha gene expression by alveolar macrophages in human lung allograft recipient with recurrence of sarcoidosis. Toulouse Lung Transplantation Group

“…Recurrence of sarcoidosis has been demonstrated in renal [2] and cardiac [3] transplantation, and two recent studies have noted it in lung transplantation [4,5]. Such cases offer a unique occasion to monitor the development of sarcoid granulomas in the lung and of local biological abnormalities potentially relevant to the pathogenesis of sarcoidosis.…”

Possible recurrence of desquamative interstitial pneumonitis in a single lung transplant recipient

“…This has already been demonstrated for sarcoidosis [10][11][12], giant cell interstitial pneumonitis [13] and lymphangioleiomyomatosis [14] in lung and also for sarcoidosis in heart [15] and renal transplants [16].…”