Lupus nephritis is a constellation of different renal histologies, characterized by an immune complex mediated glomerular disease. Histological transformation in lupus nephritis usually occurs from a mild mesangial proliferative glomerulonephritis to a more aggressive diffuse proliferative lesion. We present a case of relapsed systemic lupus erythematosus (SLE) in a renal transplant recipient in which there was a histological transformation from the original diffuse proliferative lupus nephritis in the native kidneys to a membranous lupus nephritis in the renal transplant.
Lefkowith JB , Gilkeson GS.Nephritogenic autoantibodies in lupus: current concepts and continuing controversies . Arthritis Rheum1996; 36: 894-903 .
2.
Couser WG.Pathogenesis of glomerulonephritis . Kidney Int1993; 42(suppl.): S19-S26 .
3.
Stone JH.End-stage renal disease in lupus: disease activity, dialysis, and the outcome of transplantation . Lupus1998; 7: 654-659 .
4.
Stone JH , Millward CL , Olson JL , Amend WJC , Criswell LA.Frequency of recurrent lupus nephritis among ninety-seven renal transplant patients during the cyclosporin era . Arthritis Rheum1998; 41: 678-686 .
5.
Goral S , Ynares C , Shappell SBet al.Recurrent lupus nephritis in renal transplant recipients revisited: it is not rare . Transplantation2003; 75: 651-656 .
6.
Boumpas DM , Austin HA , Fessler BJ , Barlow JE , Klippel JH , Lockshin MD.Systemic lupus erythematosus: emerging concepts . Ann Intern Med1995; 122: 940-950 .
7.
Dooley MA , Cosio FG , Nachman PHet al.Mycophenolate mofetil therapy in lupus nephritis: clinical observations . J Am Soc Nephrol1999; 10: 833-839 .
8.
Chan TM , Li FK , Tang CSOet al.Efficacy of mycophenolate mofetil in patients with diffuse lupus nephritis . N Engl J Med2000; 343: 1156-1162 .
9.
Ahuja TS , Boughton J , Weiss V , Memon, A , Remmers A , Rajaram A.Late recurrence of lupus nephritis in a renal transplant recipient: response to mycophenolate mofetil . Am J Med Sci2001; 322: 166-169 .
10.
Lentz RD , Michael AF , Friend PS.Membranous transformation of lupus nephritis . Clin Immunol Immunopath1981; 19: 131-138 .
11.
Revelo MP , Pereira MVC , Nogueira TS , Bambirra EA.Recurrence of lupus nephritis in a renal allograft with histological transformation of the lesion . Histopathol1995; 26: 292-293 .
12.
Fernandez JA , Milgrom M , Burke GW , Miller J , Roth D.Recurrence of lupus nephritis in a renal allograft with histologic transformation of the lesion . Transplantation1990; 50: 1056-1057 .
13.
Reveille JD , Barger BO , Hodge TW.HLA-DR2-DRB1 allele frequencies in DR-2 positive black Americans with and without systemic lupus erythematosus . Tissue Antigens1991; 38: 178-180 .
