腎移植後のNon-episode腎生検によって無症候性IgA腎症とサイクロスポリンによる軽度の血管性腎障害が認められた1例

Abstract

移植後8年目の46歳男にnon-episode腎生検を行い, ごく初期のサイクロスポリン血管性腎障害(CAA)と無症候性のIgA腎症の所見を得た.移植腎の病理診断及び治療法の決定において, non-episode腎生検は有効であると思われた

We report a case of subclinical immunoglobulin A (IgA) nephropathy and cyclosporin associated arteriolopathy following renal transplantation. A 39-year-old male with chronic glomerulonephritis received kidney transplantation from a two- human leukocyte antigen (HLA) mismatched cadaveric donor. The initial immunosuppressive therapy was triple-drug therapy with cyclosporin, prednisolone and mizoribine. Four months after transplantation, he had an acute rejection episode, and the renal function was recovered by steroid pulse and 15-deoxyspergualin therapy. Eight years after transplantation, we conducted a non-episode biopsy of the renal allograft to examine subclinical lesions. The histopathological findings showed cyclosporin associate arteriolopathy (CAA) and IgA nephropathy. There was no sign of acute or chronic rejection. At the present time, the renal function of the allograft is good. In conclusion, the non-episode biopsy of renal allograft is useful for examination of subclinical lesions.