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Development of a Lesion Resembling Diabetic Nephropathy in a Renal Homograft
Robert Doud, MD;
David B. N. Lee, MD;
Jerry Waisman, MD;
Jerry M. Bergstein, MD
Arch Intern Med. 1977;137(7):945-947.
Abstract
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One month following a cadaver renal transplant for obstructive uropathy, a 27-year-old man developed diabetes mellitus. Two years later, marked proteinuria and decreased renal function were detected. Eight months later, a second decline in function occurred. Light microscopy of graft biopsy specimens obtained after each decline in renal function showed increased mesangial cells and matrix, thickening of Bowman capsule, and tubular atrophy with basement membrane thickening. Vascular changes, interstitial infiltrate, and fibrosis were not prominent. Electron microscopic studies of the second biopsy specimen confirmed the light microscopic changes; subepithelial dense deposits were also detected. Immunofluorescent studies of both biopsy specimens demonstrated linear staining of glomerular and tubular basement membranes and Bowman capsule for IgG and albumin. Antikidney antibodies were not detected in the patient's serum. These observations suggest development of the diffuse form of diabetic nephropathy in a renal homograft following steroid-induced diabetes mellitus.
(Arch Intern Med 137:945-947, 1977)
Author Affiliations
From the Departments of Medicine (Drs Doud and Lee), Pathology (Dr Waisman), and Pediatrics (Dr Bergstein), University of California, Los Angeles, School of Medicine. Dr Doud is now with the Department of Medicine, Tripler Army Hospital, Honolulu.
Footnotes
Accepted for publication Sept 13, 1976.
Reprint requests to Department of Medicine, UCLA Center for the Health Sciences, Los Angeles, CA 90024 (Dr Lee).
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