Silva Rita M, Leal Rita, Marques Maria G, Rodrigues Luis, Santos Lidia, Romaozinho Catarina, Alves Rui, Figueiredo Arnaldo
From the Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Portugal.
Exp Clin Transplant. 2023 Feb;21(2):171-174. doi: 10.6002/ect.2023.0012.
Antineutrophil cytoplasm antibody-associated systemic vasculitis is a rare disease that frequently leads to end-stage renal disease. Kidney transplant should be delayed until patients are in complete clinical remission for at least 6 months, but the persistence of antineutrophil cytoplasmic antibody titers should not delay transplant. Recurrence of disease after kidney transplant is rare, with only a few cases described in the literature with heterogenous clinical manifestations, therapeutic approaches, and prognosis. We describe the case of a young male patient with recurrent antineutrophil cytoplasmic antibody vasculitis, 5 years after kidney transplant, successfully treated with methylprednisolone pulses plus rituximab. Rituximab presents a new valid option for the treatment of antineutrophil cytoplasmic antibody vasculitis relapse in kidney grafts.
抗中性粒细胞胞浆抗体相关性系统性血管炎是一种罕见疾病,常导致终末期肾病。肾移植应推迟至患者完全临床缓解至少6个月,但抗中性粒细胞胞浆抗体滴度持续存在不应延迟移植。肾移植后疾病复发罕见,文献中仅描述了少数病例,临床表现、治疗方法和预后各异。我们描述了一例年轻男性患者,肾移植5年后复发性抗中性粒细胞胞浆抗体血管炎,经甲泼尼龙冲击联合利妥昔单抗成功治疗。利妥昔单抗为治疗肾移植中抗中性粒细胞胞浆抗体血管炎复发提供了一种新的有效选择。