title: [Rapid recurrence of ANCA-MPO positive vasculitis after non-heart beating donor renal transplantation].
abstract: We report a patient with end stage renal disease with lesions compatibles with renal vasculitis antineutrophil cytoplasmic autoantibody (ANCA)-associated in phase of sclerosis that underwent renal transplantation from a non-heart beating donor after one year of haemodialysis treatment, without evidence of active vasculitis. Post-transplantation management was performed according to our protocol in this kind of donors with immunosuppressive treatment based on daclizumab, half-doses of tacrolimus, mycophenolate mofetil and steroids. In the third week the renal biopsy showed an acute necrotizing vasculitis associated with crescent glomerulonephritis. The patient was initially diagnosed of acute vascular rejection and initiated treatment with 6-metilprednisolone and anti-CD3 monoclonal anti-bodies. Two days later he developed a cutaneous purpura and the skin biopsy showed an acute necrotizing vasculitis. The determination of circulating ANCA-anti-myeloperoxidase (MPO) was positive. We initiated treatment with oral cyclophosphamide plus mycophenolate mofetil discontinuation with rapid improvement of cutaneous lesions and initiation of renal function recovery.
authors.affiliation: Unidad de Nefrología, Hospital General Universitario de Albacete, España. auroralmontes@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: López Montes
authors.forename: M
authors.initials: M
authors.lastname: Márquez Vidas
authors.forename: T
authors.initials: T
authors.lastname: Alvarez Flores
authors.forename: L
authors.initials: L
authors.lastname: González López
authors.forename: A
authors.initials: A
authors.lastname: Sánchez Fructuoso
authors.forename: J
authors.initials: J
authors.lastname: Blanco
authors.forename: A
authors.initials: A
authors.lastname: Barrientos
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000276:immunology; D012008:Recurrence; D013997:Time Factors; D014019:Tissue Donors; D014657:Vasculitis / Q000276:immunology* / Q000473:pathology / Q000601:surgery*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D009195:Peroxidase