Akash Nabeel
Renal Unit, Department of Medicine, King Hussein Medical Center, Amman, Jordan.
Saudi J Kidney Dis Transpl. 2007 Mar;18(1):91-4.
Focal segmental glomerulosclerosis (FSGS) may recur following transplantation. Approximately half of the patients with recurrent FSGS lose their grafts. We report a case of a 54-year-old woman with focal segmental glomerulosclerosis (FSGS). She underwent live-related donor kidney transplantation from her 21-year-old son and immunosuppression was maintained with tacrolimus, mycophenolate mofetil and steroids. Eight months after transplantation, the patient presented with increasing lower limbs edema and heavy proteinuria. Allograft biopsy contained 20 glomeruli of which four were totally sclerosed, seven were segmentally sclerotic, and the rest were non-sclerotic, relatively enlarged glomeruli compatible with recurrent FSGS in the graft. Plasmapheresis over a two week period with simultaneous oral cyclophosphamide resulted in a partial response of proteinuria from 12 to 2.2 g/24 hrs over 5 weeks.
局灶节段性肾小球硬化（FSGS）在肾移植后可能复发。约半数复发性FSGS患者会失去移植肾。我们报告一例54岁患有局灶节段性肾小球硬化（FSGS）的女性病例。她接受了来自其21岁儿子的活体亲属供肾移植，免疫抑制采用他克莫司、霉酚酸酯和类固醇维持。移植后8个月，患者出现双下肢水肿加重及大量蛋白尿。移植肾活检可见20个肾小球，其中4个完全硬化，7个节段性硬化，其余为非硬化、相对增大的肾小球，符合移植肾复发性FSGS表现。为期两周的血浆置换同时口服环磷酰胺，使蛋白尿在5周内从12克/24小时部分缓解至2.2克/24小时。
