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一名长期患有IgA肾病患者肾移植术后的IgA皮肤紫癜:病例报告及文献综述

IgA Cutaneous Purpura Post-Renal Transplantation in a Patient With Long-Standing IgA Nephropathy: Case Report and Literature Review.

作者信息

Sotoodian Bahman, Robert Janet, Mahmood Muhammad N, Yacyshyn Elaine

机构信息

Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada

Department of Medicine, University of Alberta, Edmonton, AB, Canada.

出版信息

J Cutan Med Surg. 2015 Sep-Oct;19(5):498-503. doi: 10.1177/1203475415582135. Epub 2015 Apr 15.

Abstract

BACKGROUND

IgA vasculitis is a small-vessel vasculitis caused by deposition of IgA antibodies in tissues. IgA nephropathy and IgAV have long been considered related conditions.

OBJECTIVE

To assess the prevalence and implications of new-onset Henoch-Schönlein purpura (HSP) after renal transplant in patients with underlying IgA nephropathy.

METHODS

The PubMed database was searched for keywords such as IgAV, IgA vasculitis, Henoch-Schönlein purpura, HSP, IgA nephropathy, and renal transplant.

RESULTS

Two cases of new-onset IgA vasculitis post-renal transplant after stopping the prednisone or receiving seasonal influenza vaccine have been reported. We report the case of new-onset IgA cutaneous vasculitis in a renal transplant patient with IgA nephropathy after reduction in his prednisone dosage.

CONCLUSION

The new development of cutaneous IgA vasculitis is unusual in renal transplant patients with IgA nephropathy. Despite these patients' being immunosuppressed, the presence of IgA vasculitis could signal the recurrence of IgA nephropathy.

摘要

背景

IgA血管炎是一种由IgA抗体在组织中沉积引起的小血管血管炎。IgA肾病和IgA血管炎长期以来一直被认为是相关疾病。

目的

评估患有潜在IgA肾病的肾移植患者中,新发过敏性紫癜(HSP)的患病率及影响。

方法

在PubMed数据库中搜索IgA血管炎、IgA肾病、过敏性紫癜、HSP、IgA肾病和肾移植等关键词。

结果

有报道称,2例肾移植患者在停用泼尼松或接种季节性流感疫苗后出现新发IgA血管炎。我们报告1例IgA肾病肾移植患者在泼尼松剂量减少后出现新发IgA皮肤血管炎的病例。

结论

IgA肾病肾移植患者出现皮肤IgA血管炎的新发病例并不常见。尽管这些患者处于免疫抑制状态,但IgA血管炎的出现可能预示着IgA肾病的复发。

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