eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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2/2019
vol. 44
 
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abstract:
Case report

A case of bizarre posttransplant anti-glomerular basement membrane disease

Anna Olewicz-Gawlik
1, 2
,
Jan Żeromski
3
,
Monika Świerczewska
4
,
Ilona Idasiak-Piechocka
5
,
Magdalena Pawlik
5
,
Dorota Sikorska
6
,
Husam Samara
3
,
Andrzej Oko
5
,
Jan Sikora
3
,
Grzegorz Dworacki
3

  1. Department of Infectious Diseases, Hepatology and Acquired Immune Deficiencies, Poznan University of Medical Sciences, Poland
  2. Department of Anatomy and Histology, University of Zielona Góra, Poland
  3. Department of Immunology, Poznan University of Medical Sciences, Poland
  4. Department of Histology and Embryology, Poznan University of Medical Sciences, Poland
  5. Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Histology Sciences, Poland
  6. Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
(Centr Eur J Immunol 2019; 44 (2): 210-213)
DOI: https://doi.org/10.5114/ceji.2019.87074
Online publish date: 2019/07/30
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The non-collagenous (NC1) domain of 3 and 5 chains of type IV collagen are eminent targets of abnormal immune response in anti-glomerular basement membrane (anti-GBM) disease, which can be diagnosed by the presence of strong linear IgG staining along GBM detected by direct immunofluorescence. The presence of linear GBM fixation in renal allograft is a rare finding. We observed a 33-year-old male with de novo renal failure in a kidney transplant. An examination of a kidney biopsy specimen revealed, in light microscopy, mild mesangial hypercellularity together with mild focal interstitial fibrosis and sparse inflammatory infiltrate. In immunofluorescence microscopy strong linear IgG staining along the capillary walls was seen. Serum anti-GBM antibodies were negative and no mutation in exons coding NC1 domains of 3 and 5 chains of type IV collagen were detected. We described a rare case of a patient with atypical anti-GBM disease in renal allograft, caused probably by the same process which affected the native kidneys.
keywords:

anti-glomerular basement membrane disease, glomerulonephritis, kidney transplantation, immunofluorescence
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