Membranous glomerulonephritis in renal transplant. A case report and review of the literature.

A patient with membranous glomerulonephritis (MGN) presented with recurrent disease after renal transplantation. The disease on the original and the transplanted kidney was characterized by diffuse subepithelial electron-dense deposits on the glomerular basement membranes. Including this case, 23 cases of MGN have been reported in renal transplants, of which 8 are 'recurrent' and 15 are 'de novo'. This incidence of 'de novo' MGN makes it the most common type of 'de novo' glomerulonephritis in renal transplants. Survey of clinical and morphological features of the cases of both the 'de novo' and the 'recurrent' disease failed to identify a specific cause of the MGN. Hypothetically, immunosuppression in transplanted patients may lower the antibody response to levels that favor the development of membranous glomerulonephritis.