[Acute allograft glomerulopathy and its etiology]

Acute allograft glomerulopathy (AAG) is a distinctive glomerular lesion of renal allografts. Its clinical signs and symptoms, pathology and etiology were studied. The frequency of AAG was 57.6% in renal transplant recipients. The clinical signs and symptoms included urinary protein, cast, WBC and RBC, etc. The pathologic features were diffuse endothelial hypertrophy and necrosis accompanied by accumulation of periodic acid-schiff (PAS) positive material and mononuclear cells that resulted in obliteration of glomerular capillaries, basilar membrane proliferation and immune complexes deposition. To elucidate the pathogenesis of AAG, we diagnosed HCMV infection of renal transplantation recipients by using polymerase chain reaction (PCR) and ELISA. Circulating T cell subsets were detected with APAAP method. OR of AAG occurrence in HCMV infection group was 32.4 times as high as in non-HCMV infection one (P < 0.01). OR of AAG occurrence in CD4/CD8 < 1.5 group was 12 times as high as in CD4/CD8 > 1.5 one (P < 0.01); so AAG was strongly associated with HCMV infection and T cell subsets changes (decreased or inverted CD4/CD8 ratio) induced by HCMV.