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Crescentic IgA Nephropathy - New York University：新月体IgA抗体肾病-纽约大学
Transplant IgAN Recurrence In 1975, only 7 years after his initial description of the entity of IgAN, Berger et al reported the first case of recurrent IgA in a renal allograft. The recurrence of IgA in transplants among patients with IgAN in their native kidneys occurred in 40-60% of cases when protocol biopsies were performed. In one study of 240 recipients, after a mean follow up of 5 years, 13% of exhibited recurrence related graft dysfunction with 5% losing the graft secondary to recurrent IgAN. Wang et al. AJKD, 38:p588, 2001. CIgAN in Transplants – Kowalewska et al A study reviewed 2959 renal biopsies over a period of 14 years and found 33 cases of glomerulonephritis with crescents (1.1%). Of these 33 cases, 8 had the diagnosis of IgAN (0.2% of total). 6 of the 8 cases were the result of recurrent IgAN, and 2 cases were presumptive de novo IgAN. 6 patients had 10-30% crescents in the glomeruli, the 2 remaining cases about 7%. Despite intensified therapy, 4 patients developed renal failure and returned to hemodialysis within 1 year. Kowalewska et al. AJKD, 45:p167, 2005. CIgAN in Transplants – Tang et al Another retrospective study reviewed 1742 allograft biopsies over a period of 9 years at a Chinese University hospital and found 18 cases with crescent formation, of which 10 patients (0.5% of total) were diagnosed with recurrent or de novo IgAN. 9 cases progressed to ESRD and returned to dialysis after 6 to 36 months. Tang et al. Renal Failure. 30:p611, 2008. CIgAN in Transplants – Mousson et al Over a 15 year period, 42 patients with biopsy proven IgAN received kidney transplants, they were followed for a mean 9 year period and had sequential allograft biopsies. In their native kidneys, 5 patients (12%) had more then 20% crescents, and only 2 (5%) had more than 50% of the glomeruli involved. 52.4% of recipients showed recurrent IgA deposits in their grafts. The 2 patients with diffuse crescentic IgAN in their native kidneys, experienced acute graft dysfu
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