Tonsillectomy in Recurrent IgA Nephropathy after Renal Transplantation

  • Kurata Natsuko
    Department of Otolaryngology, Tokyo Metropolitan Health and Medical Treatment Corporation
  • Takahashi Masatoki
    Department of Otolaryngology, Tokyo Medical and Dental University
  • Koda Hiroko
    Department of Otolaryngology, Tokyo Metropolitan Health and Medical Treatment Corporation

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Other Title
  • 腎移植後再発IgA腎症に対する口蓋扁桃摘出術の検討
  • ジンイショク ゴ サイハツ IgAジンショウ ニ タイスル コウガイ ヘントウ テキシュツジュツ ノ ケントウ

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Abstract

Many reports suggest tonsillectomy efficacy in subjects with early-stage IgA nephropathy (IgAN). Post-renal-transplant treatment in recurrent IgAN must, however, be assessed carefully. Recent reports show that tonsillectomy to also be effective in such recurrent cases. We studied 13 subjects with recurrence diagnosed histopathologically in allogenic kidney transplantation involving tonsillectomy from March 2008 to March 2010. Tonsillectomy was done on average of 74 months (15-180 months) after transplantation. Subjects averaged 44.8 years of age (29-67 years old). Buried tonsil was most common and 12 of 13 involved pus. One subject suffered slight bleeding 1 week after tonsillectomy, manageable conservatively. Steroid pulse therapy was added in 1 case after tonsillectomy due to histopathological renal biopsy suggesting severe renal injury. In most cases, serum creatinine (SCr) and urinary findings improved after tonsillectomy, which is thus expected to be effective in subjects with recurrent early-stage IgAN following renal transplantation, not only in those with IgAN.

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