17 June 2023>: Articles
A 78-Year-Old Man with Chronic Kidney Disease and Monoclonal Gammopathy Who Developed Post-Transplant C3 Glomerulopathy – Recurrence or De Novo? A Case Report and Literature Review
Challenging differential diagnosis, Rare coexistence of disease or pathology
María Carmen Ruiz-Fuentes A* , Mercedes Caba-Molina D , Aurora Polo-Moyano B , Magdalena Palomares-Bayo B , Pilar Galindo-Sacristán B , Carmen De Gracia-Guindo EDOI: 10.12659/AJCR.939726
Am J Case Rep 2023; 24:e939726
Table 1. Complementary tests.
– Blood clotting test: normal |
– Proteinuria 0.6–1 gr/24 h |
– Haptoglobin: normal. Peripheral blood smear without schistocytes |
– HBV, HCV, HIV serology: negative |
– CMV DNA quantification: negative |
– BK viremia: negative |
– Reactive C protein and procalcitonin: normal |
– Chest radiograph: normal |
– Urine culture: negative (after levofloxacin treatment) |
– C3: 46.5 mg/dl (90–180) |
– C4: 12 mg/dl (10–40) |
– Immunoglobulins: normal |
– Serum lambda and kappa chains: normal |
– Monoclonal peak IgG-lambda 0.05 gr/dl |
– ANCA: negative |
– Anti-MBG antibodies: negative |
– ENA: negative |
– ANA 1/160 |
– Anti-DNA antibodies: negative |
– HLA I: negative |
– MICA: negative |
– DQ A105: 03 and 05: low-intensity (low and stable MFI) and pre-existing |
– Mild increase of cortical echogenicity but a good corticomedullar differentiation |
– Loss of pre-existing pyelocaliceal dilation, with a minimum pelvic ectasia of 9 mm without ureteral dilation |
– Accumulation of peri-renal fluid, lower to the kidney of 3.8×2.8 cm |
– Correct kidney vascularization, IR (0.66–0.71) |
– Permeable iliac vessels. PSV in arterial anastomosis 165 cm/s |
HBV – hepatitis B virus; HCV – hepatitis C virus; HIV – human immunodeficiency virus; CMV – cytomegalovirus; ANCA – antineutrophil cytoplasmic antibodies; anti-BGM – antiglomerular basement membrane; ENA – extractable nuclear antigen antibodies; ANA – antinuclear antibodies; MICA – major histocompatibility complex class I chain-related molecule A; IR – resistive index. |