Recurrence of IgA nephropathy with nephrotic syndrome in renal allograft

A 59-year-old female presented with peripheral oedema in association with an upper respiratory tract infection in August 1980. On examination she was found to have nephrotic range proteinuria, haematuria, slightly decreased renal function and elevated blood pressure. Renal biopsy showed mesangial proliferative glomerulonephritis with mesangial IgA and C3 deposits. She was treated with corticosteroids and later with cyclophosphamide, but without any response. 1 year after the onset of disease, she developed terminal renal failure. In December 1981, she received a cadaveric renal allograft; thereafter renal function became normal but she remained proteinuric, and developed fulminant nephrosis within 2 years. A transplant biopsy revealed alterations in the graft, indicating recurrence of the original disease.