Late de novo minimal change disease in a renal allograft

Area of Science:

• Nephrology
• Transplantation Immunology
• Glomerular Diseases

Background:

• Minimal change disease (MCD) is an uncommon cause of nephrotic syndrome in renal allografts.
• Most reported cases of post-transplant MCD occur early after transplantation.
• Prognosis for MCD in renal allografts is generally favorable, though treatment strategies are not standardized.

Observation:

• A middle-aged woman presented with nephrotic syndrome 8 years post-renal allograft transplantation.
• The patient experienced a decline in allograft function concurrent with the nephrotic syndrome.
• This represents a rare late-onset presentation of minimal change disease in a functioning renal allograft.

Findings:

• The patient was diagnosed with minimal change disease affecting the renal allograft.
• Treatment with mycophenolate mofetil was initiated for the nephrotic syndrome and allograft dysfunction.
• The patient achieved remission of nephrotic syndrome and stabilization of renal allograft function.

Implications:

• This case expands the known timeline for minimal change disease presentation in renal allografts.
• It suggests mycophenolate mofetil as a potential therapeutic option for late-onset post-transplant minimal change disease.
• Highlights the importance of considering minimal change disease in the differential diagnosis of nephrotic syndrome in late-stage renal transplant recipients.