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Successful Treatment of Posttransplant Recurrent Complement C3 Glomerulopathy with Eculizumab

Hatice Sahin, Ebru Gok Oguz1, Hadim Akoglu

  • 1Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey. ebrugokoguz@hotmail.com.

Iranian Journal of Kidney Diseases
|October 28, 2018
PubMed

Insights

Recurrent C3 glomerulopathy (C3G) after kidney transplant often leads to graft loss. Eculizumab successfully treated a patient with recurrent C3G unresponsive to standard therapies, achieving complete remission.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Complement System Biology

Background:

  • C3 glomerulopathy (C3G) recurrence post-kidney transplant affects two-thirds of patients, frequently causing graft loss.
  • Standard treatment protocols for recurrent C3G in kidney transplant recipients are lacking.
  • Complement C3 dysregulation plays a critical role in the pathogenesis of C3G.

Observation:

  • A kidney transplant recipient presented with post-transplant nephrotic proteinuria, hematuria, and rising creatinine levels.
  • Graft biopsy confirmed recurrent C3 glomerulopathy (C3G).
  • Initial treatment with methylprednisolone and plasmapheresis failed to resolve the patient's C3G recurrence.

Findings:

  • Eculizumab administration led to a complete remission of recurrent C3G in the kidney transplant patient.
  • Sustained remission was observed during a 9-month maintenance eculizumab treatment period.
  • The patient's proteinuria, hematuria, and creatinine levels normalized with eculizumab therapy.

Implications:

  • Eculizumab represents a promising therapeutic option for kidney transplant patients experiencing recurrent C3G.
  • This case highlights the potential efficacy of targeting the complement system in C3G management.
  • Further research is warranted to establish eculizumab's role in treating C3G recurrence post-transplantation.

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