Successful Treatment of Posttransplant Recurrent Complement C3 Glomerulopathy with Eculizumab

Iran J Kidney Dis. 2018 Oct;12(5):315-318.

Abstract

Two-thirds of complement C3 glomerulopathy (C3G) recur after transplantation and commonly cause graft loss. There is not a standard treatment protocol for these cases. We present a kidney transplant patient with recurrent C3G who was successfully treated with eculizumab. Nephrotic proteinuria and hematuria occurred and creatinine levels increased after transplantation. A graft biopsy revealed recurrent C3G. The patient was administered 250 mg pulse methylprednisolone for 3 days and had 9 sessions of plasmapheresis. Since elevated creatinine levels and proteinuria persisted, eculizumab was instituted. A complete remission was observed after 9-month maintenance eculizumab treatment. Eculizumab may be a potentially effective option in kidney transplant patients with recurrent C3G unresponsive to other treatment modalities.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Complement C3 / metabolism*
  • Creatinine / blood
  • Glomerulonephritis / blood*
  • Glomerulonephritis / drug therapy*
  • Hematuria / etiology
  • Humans
  • Kidney Glomerulus / pathology*
  • Kidney Transplantation / adverse effects
  • Male
  • Middle Aged
  • Proteinuria / etiology
  • Recurrence

Substances

  • Antibodies, Monoclonal, Humanized
  • Complement C3
  • eculizumab
  • Creatinine