Recurrent IgG4-related tubulointerstitial nephritis concurrent with chronic active antibody mediated rejection: A case report

Rajni Chibbar, Glenda R. Wright, Pouneh Dokouhaki, Sandi Dumanski, Bhanu Prasad, Michael Mengel, Lynn D. Cornell, Ahmed Shoker

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

IgG4-related disease is a relatively newly described entity that can affect nearly any organ, including the kidneys, where it usually manifests as tubulointerstitial nephritis (IgG4-TIN). The diagnosis can be suggested by characteristic histological features, including an inflammatory infiltrate with increased IgG4-positive plasma cells associated with "storiform" fibrosis. Serum IgG4 is usually elevated. In the native kidney and other organs, there is typically a brisk response to treatment with immunosuppression. Recurrence of IgG4-TIN after renal transplant has not been described in the literature. Here, we describe the first case of recurrent IgG4-TIN in a young patient concomitant with chronic active antibody mediated rejection five years after kidney transplant. Recurrent IgG4-TIN could be diagnosed by the characteristic histopathologic features and increased IgG4-positive plasma cells. Despite maintenance immunosuppression, this disease may recur in the kidney allograft.

Original languageEnglish (US)
JournalAmerican Journal of Transplantation
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

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Keywords

  • Antibody-mediated (ABMR)
  • Clinical research/practice
  • Kidney (allograft) function/dysfunction
  • Kidney (native) function/dysfunction
  • Kidney transplantation/nephrology
  • Recurrent disease
  • Rejection

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Chibbar, R., Wright, G. R., Dokouhaki, P., Dumanski, S., Prasad, B., Mengel, M., Cornell, L. D., & Shoker, A. (Accepted/In press). Recurrent IgG4-related tubulointerstitial nephritis concurrent with chronic active antibody mediated rejection: A case report. American Journal of Transplantation. https://doi.org/10.1111/ajt.14758