title: Early and irreversible recurrence MPO-ANCA-positive glomerulonephritis after renal transplantation.
abstract: Kidney transplantation (KTx) is the treatment of choice for eligible patients suffering from anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis (AAV) who are in clinical remission, regardless of ANCA status. With current immunosuppressive protocols, the recurrence rate of this primary disease in the kidney graft is low and is generally observed after the 1st year of transplantation, with a favorable outcome following conventional treatment. We report here two unusual observations of early (diagnosed within 2 weeks) and aggressive (graft failure despite therapy) recurrences in the kidney graft. These observations suggest that systematic induction by depleting antibodies and antibiotic prophylaxis may help prevent this rare but severe condition. In addition, we monitored these patients for the anti- lysosomal membrane protein-2 antibody (LAMP2ab) titers, but we found that LAMP2ab titers were not a surrogate marker of early recurrence if the LAMP2ab concentration was higher in AVV recipients before KTx. Finally, we must keep in mind that rare cases of early and aggressive recurrence ANCA-associated vasculitis on kidney graft are a challenge for early diagnosis and treatment.
authors.forename: Ludmilla
authors.initials: L
authors.lastname: Le Berre
authors.forename: Alexandre
authors.initials: A
authors.lastname: Dufay
authors.forename: Diego
authors.initials: D
authors.lastname: Cantarovich
authors.forename: Aurélie
authors.initials: A
authors.lastname: Meurette
authors.forename: Marie
authors.initials: M
authors.lastname: Audrain
authors.forename: Magali
authors.initials: M
authors.lastname: Giral
authors.forename: Gilles
authors.initials: G
authors.lastname: Blancho
authors.forename: Fadi
authors.initials: F
authors.lastname: Fakhouri
authors.forename: Maryvonne
authors.initials: M
authors.lastname: Hourmant
authors.forename: Jacques
authors.initials: J
authors.lastname: Dantal
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology* / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D052119:Lysosomal-Associated Membrane Protein 2 / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000276:immunology*; D012008:Recurrence
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; C497811:LAMP2 protein, human; D052119:Lysosomal-Associated Membrane Protein 2; D009195:Peroxidase