Successful Treatment of Posttransplant Recurrent Complement C3 Glomerulopathy with Eculizumab

Authors

  • Hatice Sahin Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Ebru Gok Oguz Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Hadim Akoglu Department of Nephrology, Health Science University Gulhane Training and Research Hospital, Ankara, Turkey
  • Gokhan Atilgan Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Gulay Ulusal Okyay Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Guner Karaveli Gursoy Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Tugba Kip Teymur Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Dilek Ertoy Department of Pathology, Hacettepe University, Ankara, Turkey
  • Basol Canbakan Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  • Mehmet Deniz Ayli Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey

Abstract

Two-thirds of complement C3 glomerulopathy (C3G) recur after transplantation and commonly cause graft loss. There is not a standard treatment protocol for these cases. We present a kidney transplant patient with recurrent C3G who was successfully treated with eculizumab. Nephrotic proteinuria and hematuria occurred and creatinine levels increased after transplantation. A graft biopsy revealed recurrent C3G. The patient was administered 250 mg pulse methylprednisolone for 3 days and had 9 sessions of plasmapheresis. Since elevated creatinine levels and proteinuria persisted, eculizumab was instituted. A complete remission was observed after 9-month maintenance eculizumab treatment. Eculizumab may be a potentially effective option in kidney transplant patients with recurrent C3G unresponsive to other treatment modalities. 

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Published

2018-10-11

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Section

CASE REPORT | Transplantation