Table 1. Reported cases of kidney allograft PGNMID in the literature .
| References | Nasr et al 4 | Albawardi et al 5 | Sumida et al 6 | Ranghino et al 7 | Wu et al 8 | Batal et al 9 |
| No. of cases | 4 | 4 | 1 | 1 | 1 | 9 |
|
Recurrent/ de novo |
All recurrent | 2 recurrent, 2 de novo | Recurrent | Recurrent | Recurrent | No information |
| Native kidney disease | 2 with MPGN and 2 with endocapillary proliferative patterns of PGNMID | 2 with PGNMID, 1 with PKD, 1 with diabetic nephropathy | Endocapillary proliferative pattern of PGNMID | Crescentic endocapillary proliferative pattern of PGNMID | Mesangial proliferative pattern of MPGN |
Unclear how many had biopsy. 2 with MPGN |
| Clinical presentation post-transplant | Proteinuria, microhematuria, rising creatinine | Proteinuria, rising creatinine | Proteinuria, microhematuria, rising creatinine | Proteinuria, rising creatinine | Proteinuria | 1 with proteinuria, hematuria, rising creatinine. No data on the rest |
| Time from transplant to diagnosis | 3-5 months | Recurrent: 12-13 months, De novo: 14-30 months | 4 months | 18 months | 19 months | 5 months to 22 years |
| Allograft biopsy findings | 2 with mesangial proliferative and 2 with endocapillary proliferative pattern of PGNMID with monotypic glomerular IgG3 in all | 2 with MPGN (glomerular IgG3 in one and IgG1 in other); 1 with BK nephropathy and mesangial IgG3;1 with ATN and mesangial IgG3 | Endocapillary proliferative pattern of PGNMID with glomerular capillary and mesangial IgG2 staining | Endocapillary proliferative pattern of PGNMID with light chain kappa staining |
Mesangial proliferative pattern of PGNMID with Glomerular IgG3 staining |
7 with MPGN, 1 with ATN 6 had IgG stain (3 IgG3, 2 IgG 1). 2 had IgA stain |
| Treatment | Steroid + rituximab in 3 patients; steroid + cyclophosphamide in 1 patient | No specific therapy | High dose steroid | Pulse steroid + plasmapheresis + IVIG | Steroid +cyclo- phosphamide + double filtration plasmapheresis | Not mentioned |
| Outcome | Improved allograft function in 3 patients | Death with functioning graft in 2 (I cardiac, 1 infection); dialysis in 1; rising creatinine in 1 | Improvement in allograft function and proteinuria |
Initial improvement. Patient underwent transplant nephrectomy 6 months later |
Infection related death with functioning graft | 3 allografts failed, 3 functioning, no information available on 3 patients. |
Abbreviations: ATN, acute tubular necrosis; MPGN, membrano-proliferative glomerulonephritis; PGNMID, proliferative glomerulonephritis with monoclonal immunoglobulin deposits; PKD, polycystic kidney disease.