Repository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation

Introduction: De-novo C3 glomerulonephritis (C3GN) post-transplant is uncommon. Although eculizumab has been used successfully in several cases, the response is heterogeneous and treatment strategies remain undefined. The use of repository corticotropin in C3GN has not been described in the literatu...

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Autores principales:	Muhammad Saad Naseer, Ayush Singh, Neeraj Singh
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/290bca6c394f4e81afb2c8d4c95e74a4
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spelling	oai:doaj.org-article:290bca6c394f4e81afb2c8d4c95e74a42021-11-18T11:08:47ZRepository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation2673-363310.1159/000520387https://doaj.org/article/290bca6c394f4e81afb2c8d4c95e74a42021-10-01T00:00:00Zhttps://www.karger.com/Article/FullText/520387https://doaj.org/toc/2673-3633Introduction: De-novo C3 glomerulonephritis (C3GN) post-transplant is uncommon. Although eculizumab has been used successfully in several cases, the response is heterogeneous and treatment strategies remain undefined. The use of repository corticotropin in C3GN has not been described in the literature. Case Report: A 48-year-old African American male with kidney transplantation secondary to presumed diabetic nephropathy presented six years post-transplant with lower extremity edema and nephrotic range proteinuria. His urine protein to creatinine ratio (UPCR) was 8.2 g/g. Renal allograft biopsy confirmed the diagnosis of C3GN. He was treated with eculizumab (Solaris®) 900 mg IV once weekly for four weeks and repository corticotropin (H.P. Acthar® gel) 80 units SQ twice weekly for six months with a near-complete resolution of proteinuria within three months of the treatment. The patient presented again six months after completing the therapy with a recurrence of proteinuria, which peaked at 11.6 g/g of UPCR. Repeat kidney allograft biopsy was consistent with C3GN. He was started on repository corticotropin 80 units SQ twice weekly, which resulted in a reduction of proteinuria to >50% within two months of therapy. When eculizumab 900 mg IV weekly for four weeks was added with repository corticotropin, the proteinuria resolved within ten weeks of treatment. The patient was maintained on monotherapy of repository corticotropin and has been in complete remission of proteinuria for more than a year until his last follow-up. Conclusion: In conclusion, this is the first case report describing the role of repository corticotropin as an effective therapy in reducing proteinuria and maintaining patients with C3GN in proteinuria remission.Muhammad Saad NaseerAyush SinghNeeraj SinghKarger PublishersarticleDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENGlomerular Diseases (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	Diseases of the endocrine glands. Clinical endocrinology RC648-665 Muhammad Saad Naseer Ayush Singh Neeraj Singh Repository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation
description	Introduction: De-novo C3 glomerulonephritis (C3GN) post-transplant is uncommon. Although eculizumab has been used successfully in several cases, the response is heterogeneous and treatment strategies remain undefined. The use of repository corticotropin in C3GN has not been described in the literature. Case Report: A 48-year-old African American male with kidney transplantation secondary to presumed diabetic nephropathy presented six years post-transplant with lower extremity edema and nephrotic range proteinuria. His urine protein to creatinine ratio (UPCR) was 8.2 g/g. Renal allograft biopsy confirmed the diagnosis of C3GN. He was treated with eculizumab (Solaris®) 900 mg IV once weekly for four weeks and repository corticotropin (H.P. Acthar® gel) 80 units SQ twice weekly for six months with a near-complete resolution of proteinuria within three months of the treatment. The patient presented again six months after completing the therapy with a recurrence of proteinuria, which peaked at 11.6 g/g of UPCR. Repeat kidney allograft biopsy was consistent with C3GN. He was started on repository corticotropin 80 units SQ twice weekly, which resulted in a reduction of proteinuria to >50% within two months of therapy. When eculizumab 900 mg IV weekly for four weeks was added with repository corticotropin, the proteinuria resolved within ten weeks of treatment. The patient was maintained on monotherapy of repository corticotropin and has been in complete remission of proteinuria for more than a year until his last follow-up. Conclusion: In conclusion, this is the first case report describing the role of repository corticotropin as an effective therapy in reducing proteinuria and maintaining patients with C3GN in proteinuria remission.
format	article
author	Muhammad Saad Naseer Ayush Singh Neeraj Singh
author_facet	Muhammad Saad Naseer Ayush Singh Neeraj Singh
author_sort	Muhammad Saad Naseer
title	Repository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation
title_short	Repository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation
title_full	Repository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation
title_fullStr	Repository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation
title_full_unstemmed	Repository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation
title_sort	repository corticotropin in treating de-novo c3 glomerulonephritis post-transplantation
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/290bca6c394f4e81afb2c8d4c95e74a4
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Repository Corticotropin in Treating De-Novo C3 Glomerulonephritis Post-Transplantation

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