title: Induction treatment of previously undiagnosed ANCA-associated vasculitis in a renal transplant patient with Rituximab.
abstract: We report the case of a 40-year-old female transplant patient with undiagnosed ANCA-associated vasculitis (AAV) and renal allograft dysfunction who achieved disease remission with restoration of transplant function following induction therapy with rituximab. There are currently no trial data looking at the use of rituximab for induction of remission of renal transplant patients with AAV. Although recurrence of AAV following renal transplantation is rare, such patients have invariably had multiple previous exposures to induction and maintenance immunosuppressive regimens, often limiting treatment options post-transplantation. In this case, rituximab was well tolerated with no side effects, and was successful in salvaging transplant function. Optimal treatment regimens for relapsed AAV in the transplant population are not known, and clinical trials are needed to evaluate the efficacy and safety of rituximab at inducing and maintaining disease remission in relapsed AAV following transplantation.
authors.affiliation: John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK; National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK.
authors.forename: M P M
authors.initials: MP
authors.lastname: Graham-Brown
authors.affiliation: John Walls Renal Unit , University Hospitals of Leicester NHS Trust , Leicester , UK.
authors.forename: R
authors.initials: R
authors.lastname: Aljayyousi
authors.affiliation: John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Baines
authors.affiliation: John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
authors.forename: J O
authors.initials: JO
authors.lastname: Burton
authors.affiliation: John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Brunskill
authors.affiliation: Department of Histopathology , University Hospitals of Leicester NHS Trust , Leicester , UK.
authors.forename: P
authors.initials: P
authors.lastname: Furness
authors.affiliation: John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
authors.forename: P
authors.initials: P
authors.lastname: Topham
keywords: ANCA; Renal; Rituximab; Transplantation