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Case Reports: Unusual association of diseases/symptoms
Early recurrence of focal segmental glomerulosclerosis in a kidney transplant recipient with APOL1 one risk variant
  1. Ratna Acharya1 and
  2. Kiran Upadhyay2
  1. 1Paediatrics, University of Florida, Gainesville, Florida, USA
  2. 2Paediatrics and Nephrology, University of Florida Health, Gainesville, Florida, USA
  1. Correspondence to Kiran Upadhyay; dockiranbp{at}yahoo.com

Abstract

Apolipoprotein 1 (APOL1) risk variants (G1 and G2) are associated with focal segmental glomerulosclerosis (FSGS) in patients of African ancestry. The prevalence of APOL1 two risk variants is lower in Hispanics and very rare in European and Asian populations. APOL1 two risk variants in donor kidneys is associated with recipient kidney graft loss, however the effect of recipient risk variant in the kidney transplant outcome is unclear. Here, we present a late adolescent male with FSGS and end stage renal disease with one APOL1 risk variant (G2) who had immediate recurrence of FSGS in the post-KT period. There was an excellent response to few sessions of plasmapheresis and Rituximab with no further recurrence of FSGS in the 1 year follow-up period. It needs to be seen whether the recipient APOL1 single risk variant causes increased susceptibility to kidney graft loss on a long run via recurrent or de novo pathologies.

  • Renal system
  • Renal medicine
  • Renal transplantation
  • Nephrotic syndrome
  • Transplantation

https://doi.org/10.1136/bcr-2023-254593

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    Footnotes

    • Contributors RA and KU were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. RA and KU gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.