Minimal Change Disease as a Secondary and Reversible Event of a Renal Transplant Case with Systemic Lupus Erythematosus

Elena Gkrouzman; Kyriakos A Kirou; Surya V Seshan; James M Chevalier

doi:10.1155/2015/987212

Minimal Change Disease as a Secondary and Reversible Event of a Renal Transplant Case with Systemic Lupus Erythematosus

Case Rep Nephrol. 2015:2015:987212. doi: 10.1155/2015/987212. Epub 2015 Aug 13.

Authors

Elena Gkrouzman¹, Kyriakos A Kirou², Surya V Seshan³, James M Chevalier⁴

Affiliations

¹ University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1235, USA.
² Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
³ New York-Presbyterian Hospital, 525 East 68th Street, Starr Pavilion 1009, New York, NY 10021, USA.
⁴ Rogosin Kidney Center, 505 East 70th Street, New York, NY 10021, USA.

Abstract

Secondary causes of minimal change disease (MCD) account for a minority of cases compared to its primary or idiopathic form and provide ground for consideration of common mechanisms of pathogenesis. In this paper we report a case of a 27-year-old Latina woman, a renal transplant recipient with systemic lupus erythematosus (SLE), who developed nephrotic range proteinuria 6 months after transplantation. The patient had recurrent acute renal failure and multiple biopsies were consistent with MCD. However, she lacked any other features of the typical nephrotic syndrome. An angiogram revealed a right external iliac vein stenosis in the region of renal vein anastomosis, which when restored resulted in normalization of creatinine and relief from proteinuria. We report a rare case of MCD developing secondary to iliac vein stenosis in a renal transplant recipient with SLE. Additionally we suggest that, in the event of biopsy-proven MCD presenting as an atypical nephrotic syndrome, alternative or secondary, potentially reversible, causes should be considered and explored.