Kumano K, Sakai T, Mashimo S, Endo T, Koshiba K, Elises J S, Iitaka K
Clin Nephrol. 1987 Feb;27(2):94-8.
A case of recurrent lupus nephritis in an 18-year-old girl with a renal transplant is described. Serological titer of ANA and Anti-DNA were low prior to renal transplantation following pulse therapy with methylpredonisolone and high dose oral predonisolone. A living related transplantation was performed after 6 months of hemodialysis. Maintenance immunosuppressive therapy consisted of predonisolone, mizoribine and cyclophosphamide. Graft function remained stable for one and half years after transplantation. Clinical recurrence was heralded by the development of proteinuria. If the serologic activities had been analyzed, the increase in ANA and Anti-DNA titers a few months before the onset of proteinuria might have predicted a possible histopathological recurrence. Fortunately, however, despite the histological and clinical recurrence of systemic lupus erythematosus, her renal allograft has continued to function fairly well.
本文描述了一名18岁接受肾移植的女孩复发性狼疮性肾炎的病例。在接受甲泼尼龙冲击治疗及大剂量口服泼尼松龙后，肾移植术前抗核抗体（ANA）和抗DNA抗体的血清学滴度较低。血液透析6个月后进行了亲属活体肾移植。维持性免疫抑制治疗包括泼尼松龙、咪唑立宾和环磷酰胺。移植后1年半移植物功能保持稳定。蛋白尿的出现预示着临床复发。如果分析血清学活性，蛋白尿出现前几个月ANA和抗DNA滴度的升高可能预示着组织病理学复发。然而，幸运的是，尽管系统性红斑狼疮出现了组织学和临床复发，她的同种异体肾移植仍继续良好地发挥功能。
