Abstract: FR-PO1168
Non-Lupus Full-House Nephropathy in Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Author
- Agarwal, Devendra Kumar, Apollo Delhi, New Delhi, India
Introduction
Non Lupus full house Nephropathy is a rare entity that is still poorly understood. It can complicate kidney allograft and there is not much of the treatment available as of now. Subsequently most patients lose their grafts. Non lupus full house nephropathy is described by full house (IgG, IgA, IgM, C3 and C1q) on Immunofluorescence in the absence of classical diagnostic features of SLE including serology.
Case Description
Case1 - 49 year old male with history of live donor ABO compatible kidney transplant in 2017 with stable graft function up till 2023 when he presented with creeping creatinine and proteinuria. Graft biopsy revealed endo capillary hypercellularity with fibrinoid necrosis, leukocyte infiltration and wire-loop lesions. Patient was given rituximab four doses 500mg weekly. After 4 weeks of follow up serum creatinine stabilized and UPCR improved which was maintained up to 1 year. However, he had LRTI (pneumocystis jirovecii) infection and CMV viremia. Subsequently we lost the patient after 1.5 years.
Case2 - 52 year old female with history of live donor ABO compatible kidney transplant in 2015 with stable graft function up till 2023 when she presented with creeping creatinine and proteinuria. Graft biopsy revealed DPGN. Injection rituximab 500 mg 3 doses given. After 4 weeks of follow up serum creatinine stabilized and UPCR improved which was maintained for 2 years and subsequently she lost the graft and started on maintenance haemodialysis.
Case3 - 53 year old male with history of live donor ABO compatible kidney transplant in 2007 with stable graft function up in 2025 when he presented with creeping creatinine and nephrotic proteinuria. Graft biopsy revealed membrano-proliferative pattern of glomerulonephritis. Injection Rituximab 1 gram 2 doses were given 15 days apart. After 6 weeks of follow up serum creatinine stabilized and Proteinuria resolved, which was maintained up till 4 months and later he died due to severe chest infection.
Discussion
The significance of full house Nephropathy in kidney transplant recipients is not well known. Said et al retrospectically analysed 24 allograft biopsies with intense C1q deposition and concluded that it is a morphological pattern with no clinical significance. however in our all 3 patients serum creatinine and proteinuria improved markedly.
Acknowledgment
There is no conflict of interest and there is no additional financial support.
we thank the nephrology department of apollo hospital and co-authors.