适当免疫抑制肾移植患者复发抗中性粒细胞细胞质抗体相关血管炎:两例的讨论。

Case reports in nephrology and urology Pub Date : 2013-01-01 Epub Date: 2013-01-27 DOI:10.1159/000347142
Frank J O'Brien, Ahad Abdalla, Limy Wong, Carol A Traynor, Paul Cheriyan, Hong Kwan Kok, Liam Casserly, Anthony Dorman, Peter J Conlon
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引用次数: 3

摘要

背景:多血管炎肉芽肿病(GPA)是一种病因不明的多系统自身免疫性疾病。肾脏疾病表现为新月形肾小球肾炎,伴不同程度的肾功能衰竭。10%的患者会发展为终末期肾病。肾移植患者的GPA复发是罕见的,每例患者每年复发0.09次。患者和方法:我们描述了2例免疫抑制肾移植患者的GPA复发。结果:这些患者表现为新发移植物功能障碍,之前有一个简单的移植后过程。两名患者在复发时都服用了适当剂量的免疫抑制剂,治疗目标水平为他克莫司。我们描述了这两个病人的背景、病史和治疗方法。结论:本文所描述的病例告诉我们,尽管抗中性粒细胞细胞质抗体血管炎在移植患者中复发是罕见的,但它仍应作为同种异体移植功能障碍的鉴别诊断之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Recurrence of anti-neutrophil cytoplasmic antibody-associated vasculitis in appropriately immunosuppressed renal transplant patients: a discussion of two cases.

Recurrence of anti-neutrophil cytoplasmic antibody-associated vasculitis in appropriately immunosuppressed renal transplant patients: a discussion of two cases.

Recurrence of anti-neutrophil cytoplasmic antibody-associated vasculitis in appropriately immunosuppressed renal transplant patients: a discussion of two cases.

Recurrence of anti-neutrophil cytoplasmic antibody-associated vasculitis in appropriately immunosuppressed renal transplant patients: a discussion of two cases.

Background: Granulomatosis with polyangiitis (GPA) (formerly known as Wegener's granulomatosis) is a multisystem autoimmune disease of unknown aetiology. Renal disease manifests as a crescentic glomerulonephritis, with varying degrees of renal failure. Ten percent of patients progress to end-stage kidney disease. Relapse of GPA in renal transplant patients is rare, with a rate of 0.09 relapses per patient per year.

Patients and methods: We describe two cases of GPA relapse in immunosuppressed renal transplant patients.

Results: These patients presented with new-onset graft disfunction, having previously had an uncomplicated posttransplant course. Both patients were on appropriate doses of immunosuppressive agents at the time of relapse, with therapeutic target levels of tacrolimus. We describe the background history and management of both patients.

Conclusion: The cases described inform us that although recurrence of anti-neutrophil cytoplasmic antibody vasculitis in transplant patients is rare, it should remain on our list of differential diagnoses in allograft disfunction.

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