Rapid catastrophic onset of Wegener's granulomatosis in a renal transplant.

A 62-year-old man with chronic renal failure secondary to Wegener's granulomatosis received a cadaveric renal graft in December 1990 after 2 years' treatment with continuous ambulatory peritoneal dialysis. Early graft function was good and serum creatinine fell steadily. On day 5 he became anuric and the graft became swollen and tender. Isotope renography showed no perfusion and the kidney was removed. Pathological examination showed widespread acute arteritis consistent with recurrent Wegener's granulomatosis. Recurrence of Wegener's granulomatosis in renal grafts is rare. The 4 previously reported cases are reviewed.