Fonck C, Loute G, Cosyns J P, Pirson Y
Department of Nephrology and Pathology, University of Louvain Medical School, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.
Am J Kidney Dis. 1998 Aug;32(2):323-7. doi: 10.1053/ajkd.1998.v32.pm9708621.
True recurrence of anti-glomerular basement membrane (anti-GBM) nephritis is very rare, both in native kidneys and after renal transplantation. We report the recurrence of fulminant anti-GBM nephritis in a kidney graft recipient after the spontaneous withdrawal of immunosuppressive treatment more than 5 years after renal transplantation. The initial episode of anti-GBM nephritis had destroyed the native kidneys 7 years earlier. Circulating anti-GBM antibodies had disappeared for 14 months at the time of transplantation and reappeared with recurrence. This observation challenges the concept of anti-GBM nephritis as a single-shot illness and emphasises the need to consider the possibility of recurrence, even in the long term, among patients who underwent transplantation for anti-GBM nephritis.
抗肾小球基底膜（anti-GBM）肾炎的真正复发非常罕见，无论是在自体肾还是肾移植后。我们报告了1例肾移植受者在肾移植5年多后自行停用免疫抑制治疗后，暴发性抗GBM肾炎复发的病例。抗GBM肾炎的初始发作在7年前已破坏了其自体肾。移植时循环抗GBM抗体已消失14个月，复发时再次出现。这一观察结果挑战了抗GBM肾炎为一次性疾病的概念，并强调即使在长期，对于因抗GBM肾炎接受移植的患者，也需要考虑复发的可能性。
