RT Book, Section
A1 Bijol, Vanesa
A2 Molmenti, Ernesto Pompeo
SR Print(0)
ID 1194189382
T1 Recurrent Primary Focal Sclerosis
T2 Molmenti’s Kidney and Pancreas Transplantation: Operative Techniques and Medical Management, 2e
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781260474275
LK accesssurgery.mhmedical.com/content.aspx?aid=1194189382
RD 2024/04/23
AB 28-year-old  woman  with  end  stage  kidney  disease  secondary  to  steroid  resistant  nephrotic  syndrome  who  received  a  living  related  donor  kidney.  Although  she  had  immediate  urine  output  and  good  renal  function,  on  the  second  postoperative  day  she  exhibited  a  decrease  in  output  coupled  with  an  increase  in  creatinine  values.  Duplex  Doppler  ultrasound  evaluation  showed  good  perfusion  of  the  kidney  and  no  evidence  of  hydronephrosis.  Dipstick  revealed  3+  proteinuria.Allograft  biopsy  showed  non-specific  changes  on  light  microscopy  (Figure  112-77)  and  extensive  effacement  of  podocyte  foot  processes  on  electron  microscopy  (Figure  112-78),  suggesting  recurrent  diffuse  podocyte  disease  due  to  circulating  factor  (recurrent  primary  focal  sclerosis  or  FSGS).  Initially,  these  lesions  have  no  segmental  or  global  sclerosis,  but  have  an  appearance  equivalent  to  minimal  change  disease  (MCD),  suggesting  that  MCD  and  primary  FSGS  are  two  ends  of  the  same  disease  spectrum.