De novo minimal change disease after kidney transplantation

Post-transplant glomerular diseases (PTGN) have been documented frequently, although majority of them, are recurrences of primary diseases. In some cases, de novo glomerular diseases can develop in recipients. In this paper, a case of de novo minimal change disease (MCD) after non-related live donor kidney transplantation in a patient with a history of biopsy proven membranous nephropathy is described. A 25-year-old man with history of biopsy-proven idiopathic membranous glomerulopathy (MGN) who had been transplanted 3 weeks before referred to hospital, presented with peripheral edema and massive proteinuria. First kidney biopsy was compatible with acute cellular rejection with glomerulitis. The patient was treated with methylprednisolone. Panel reactive antibody (PRA) and C4d were negative. Anti- phospholipase A2 receptor (PLA2R) antibody was also negative. Another allograft biopsy was conducted and the result was highly suggestive of MCD. Thus final diagnosis was de novo MCD and proteinuria decreased successfully.