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[Glomerulonephritis caused by acute serum sickness]

M B Andrésdóttir1, K J Assmann, J F Wetzels

  • 1Afd. Nierziekten, Academisch Ziekenhuis, Nijmegen.

Nederlands Tijdschrift Voor Geneeskunde
|July 19, 1997
PubMed
Summary

Serum sickness can occur after horse antithymocyte globulin (ATG) treatment for kidney transplant rejection. This condition involves fever, joint pain, and kidney failure due to immune complex formation, but typically resolves on its own.

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Area of Science:

  • Nephrology
  • Immunology
  • Transplantation

Background:

  • Kidney transplantation is a common treatment for end-stage renal disease.
  • Rejection episodes can occur post-transplantation, necessitating immunosuppressive therapy.
  • Horse antithymocyte globulin (ATG) is frequently used to manage kidney transplant rejection.

Observation:

  • A 51-year-old male developed symptoms 12 days after initiating horse ATG treatment for kidney transplant rejection.
  • Clinical presentation included fever, arthralgia, purpura, and acute renal failure.
  • These symptoms are characteristic of serum sickness, an immune complex-mediated condition.

Findings:

  • Kidney biopsy confirmed endocapillary glomerulonephritis.
  • The findings suggest immune complex deposition in the glomeruli.
  • These complexes likely formed from antibodies against horse ATG and precipitated from circulation.

Implications:

  • This case highlights a potential adverse reaction to horse ATG in kidney transplant recipients.
  • Serum sickness, though serious, generally follows a course of spontaneous recovery.
  • Awareness of this complication is crucial for timely diagnosis and management in transplant patients.

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