Early Recurrence of C3 Glomerulopathy Postrenal Transplant Manifesting as Atypical Hemolytic Uremic Syndrome: A Phenotype Switch

Kidney transplantation is the best treatment option for end-stage kidney disease patients. Long-term survival of the allograft is a crucial component of medical care because of the expense and complications of the surgical procedure. C3 glomerulopathy (C3G) is the primary glomerular disease with a very high recurrence rate postrenal transplantation. Atypical hemolytic uremic syndrome (aHUS) shares common genetic risk factors with C3G. Few cases were reported earlier regarding phenotype shifts between C3G and aHUS. However, recurrence of C3G immediate postrenal transplant as aHUS is an extremely rare phenomenon. This patient did not respond to plasmapheresis but showed excellent response to eculizumab and completely recovered the graft function. There are no guidelines for the prevention or treatment of the recurrence of C3G in kidney transplant patients and requires further discussion.