An unexpected diagnosis in a renal-transplant patient with proteinuria treated with everolimus: AL amyloidosis.

Abstract

Proteinuria is an expected complication in transplant patients treated with mammalian target of rapamycin inhibitors (mTOR-i). However, clinical suspicion should always be supported by histological evidence in order to investigate potential alternate diagnoses such as acute or chronic rejection, interstitial fibrosis and tubular atrophy, or recurrent or de novo glomerulopathy. In this case we report the unexpected diagnosis of amyloidosis in a renal-transplant patient with pre-transplant monoclonal gammapathy of undetermined significance who developed proteinuria after conversion from tacrolimus to everolimus.

• Authors: Joelle Guitard, Celine Guilbeau-Frugier, Murielle Roussel, Nassim Kamar
• Journal: Clinical nephrology (Clin Nephrol) Vol. 82 Issue 6 Pg. 392-6 (Dec 2014) ISSN: 0301-0430 [Print] Germany
• PMID: 24040781 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulin G
• Immunoglobulin lambda-Chains
• Immunosuppressive Agents
• Everolimus
• TOR Serine-Threonine Kinases
• Tacrolimus

Topics

• Allografts (transplantation)
• Amyloidosis (diagnosis)
• Diagnosis, Differential
• Everolimus (therapeutic use)
• Female
• Humans
• Immunoglobulin G (immunology)
• Immunoglobulin lambda-Chains (immunology)
• Immunosuppressive Agents (therapeutic use)
• Kidney Diseases (diagnosis)
• Kidney Transplantation
• Middle Aged
• Paraproteinemias (complications)
• Polycystic Kidney, Autosomal Dominant (surgery)
• Postoperative Complications
• Proteinuria (etiology)
• TOR Serine-Threonine Kinases (antagonists & inhibitors)
• Tacrolimus (therapeutic use)