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[Lipoprotein glomerulopathy: a new French case with recurrence on the transplant]
A Djamali1, J P Cristol, C Turc-Baron
1Service de Néphrologie, Hôpital Lapeyronie, CHU de Montpellier, Paris.
Insights
Lipoprotein glomerulopathy, characterized by lipid deposits in kidney capillaries, can recur after kidney transplantation. This case highlights the importance of monitoring lipid profiles and ApoE in transplant recipients with this rare glomerular disease.
Area of Science:
- Nephrology
- Pathology
- Genetics
Background:
- Lipoprotein glomerulopathy (LPG) is a rare kidney disease characterized by lipidic deposits in glomerular capillaries.
- It is associated with quantitative or qualitative alterations in plasma apolipoprotein E (ApoE).
- Patients often present with nephrotic syndrome and progress to chronic kidney disease.
Abstract:
Lipoprotein glomerulopathy is defined by the presence of lipidic deposits in the capillary lumen giving them a dialted and microaneurysmal aspect and the presence of quantitative and/or qualitative alterations of plasma apolipoprotein E. We describe here the long-term follow-up of a young female patient who presented with corticoresistant nephrotic syndrome in 1979 and progressed to chronic renal failure requiring dialysis in 1990. The three renal biopsies performed during the follow-up showed markedly enlarged capillary loops due to intra-luminal fibrinolipidic material deposition forming true intracapillary thrombi. She received a cadaver renal transplant in 1993. One year after transplantation, nephrotic syndrome reappeared and graft biopsy showed recurrence of the initial glomerular disease on the transplant. The plasma lipid profile showed hypercholesterolemia, hypertriglyceridemia, and elevated plasma ApoE levels with an abnormal Apo E phenotype. Our case report is a new typical case of lipoprotein glomerulopathy with recurrence of the initial disease on the renal allograft.