Effective Treatment of a Post-renal Transplantation Patient with Early Recurrent Focal Segmental Glomerulosclerosis and Concomitant Hemolytic Uremic Syndrome, a Case Report
Abdullah Alsawadi *
Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Majed Aloufi
Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Ahmed Fatta
Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Sahar Almowaina
Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Mugahid Elamin
Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Hamad Albahili
Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Rafat Zahid
Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Ali Alyami
Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
While recurrence of primary Focal Segmental Glomerular Sclerosis (FSGS) is common post renal transplantation (30%-80%), a concomitant presentation of hemolytic uremic syndrome (HUS) and recurrent FSGS has never been reported. In addition, treatment of recurrent FSGS and HUS post-renal transplantation is challenging; and usually individualized based on center's experience. Here, we reported a case of a pediatric patient with early recurrence of FSGS and concomitant HUS post-renal transplantation. This patient had a complete hematological and renal response following the administration of Eculizumab and Rituximab, respectively. Withdrawal of Tacrolimus as well as plasmapheresis did not improve kidney function. Therefore, we concluded that both Eculizumab and Rituximab could achieve remission in comparable cases when administered at fixed intervals.
Keywords: Recurrent Focal Segmental Glomerular Sclerosis, hemolytic uremic syndrome, renal transplantation