A case of recurrent focal segmental glomerulosclerosis with cellular lesions soon after living-related renal transplantation: A possible association of the plasma circulating factors with clinicopathologic features

Abstract

 We report a 12-year-old girl with recurrent focal segmental glomerulosclerosis with cellular lesions developing soon after living-related renal transplantation. Her graft function progressively deteriorated until she finally developed end-stage renal disease. We studied the association of the plasma circulating factors with clinicopathologic features.
 We treated cultured podocytes with her plasma and examined the time-course of integrin-linked kinase (ILK) activity, alterations of focal contacts, and detachments of cultured podocytes from culture dishes coated with laminin-1. We observed an increase in ILK activity, focal contacts were disassembled, and some cultured podocytes were detached from the laminin matrix.
 We speculated that circulating toxic factors in her plasma induced an increase in podocyte ILK activity that promoted the detachment of podocytes from the GBM. Podocyte detachment might be associated with the formation of cellular lesions, massive proteinuria, and glomerulosclerosis, which all led to the progressive decline of her graft function.