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Post-transplant immune complex nephritis in a patient with systemic lupus erythematosus associated with ANCA vasculitis.
Pediatr Transplant 2017; 21(3)PT

Abstract

Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys. A 17-year-old female with crescentic glomerulonephritis, p-ANCA-positive antibodies with pauci-immune pattern in kidney biopsy develops end-stage renal disease requiring hemodialysis. Deceased donor kidney transplant was performed receiving triple immunosuppression thereafter. Thirteen months later serum creatinine rises without evidence of infection, urinary obstruction, or clinical and serologic disease relapse. Allograft biopsy reports mesangial proliferation and "full-house" immunofluorescence. The role of ANCA in SLE physiopathology is controversial, and its relation with lupus nephritis is also discordant. ANCA could represent an important factor in the heterogeneity of systemic lupus erythematosus and lupus nephritis.

Authors+Show Affiliations

Resident of Pediatric Nephrology, National Institute of Pediatrics, México City, Mexico.Resident of Pediatric Nephrology, National Institute of Pediatrics, México City, Mexico.Resident of Pediatric Nephrology, National Institute of Pediatrics, México City, Mexico.Anatomic-Pathology Department, National Institute of Pediatrics, México City, Mexico.Pediatric Nephrology Department, National Institute of Pediatrics, México City, Mexico.Pediatric Nephrology Department, National Institute of Pediatrics, México City, Mexico.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

28133935

Citation

Sanchez, Carlos, et al. "Post-transplant Immune Complex Nephritis in a Patient With Systemic Lupus Erythematosus Associated With ANCA Vasculitis." Pediatric Transplantation, vol. 21, no. 3, 2017.
Sanchez C, Rebolledo A, Gahona J, et al. Post-transplant immune complex nephritis in a patient with systemic lupus erythematosus associated with ANCA vasculitis. Pediatr Transplant. 2017;21(3).
Sanchez, C., Rebolledo, A., Gahona, J., Rojas, M., Jiménez, R., & Bojórquez, A. (2017). Post-transplant immune complex nephritis in a patient with systemic lupus erythematosus associated with ANCA vasculitis. Pediatric Transplantation, 21(3), doi:10.1111/petr.12895.
Sanchez C, et al. Post-transplant Immune Complex Nephritis in a Patient With Systemic Lupus Erythematosus Associated With ANCA Vasculitis. Pediatr Transplant. 2017;21(3) PubMed PMID: 28133935.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-transplant immune complex nephritis in a patient with systemic lupus erythematosus associated with ANCA vasculitis. AU - Sanchez,Carlos, AU - Rebolledo,Alejandra, AU - Gahona,Junior, AU - Rojas,Mauricio, AU - Jiménez,Raquel, AU - Bojórquez,Aurora, Y1 - 2017/01/29/ PY - 2017/01/04/accepted PY - 2017/1/31/pubmed PY - 2017/10/27/medline PY - 2017/1/31/entrez KW - ANCA KW - kidney transplantation KW - lupus nephritis KW - systemic lupus erythematosus KW - vasculitis JF - Pediatric transplantation JO - Pediatr Transplant VL - 21 IS - 3 N2 - Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys. A 17-year-old female with crescentic glomerulonephritis, p-ANCA-positive antibodies with pauci-immune pattern in kidney biopsy develops end-stage renal disease requiring hemodialysis. Deceased donor kidney transplant was performed receiving triple immunosuppression thereafter. Thirteen months later serum creatinine rises without evidence of infection, urinary obstruction, or clinical and serologic disease relapse. Allograft biopsy reports mesangial proliferation and "full-house" immunofluorescence. The role of ANCA in SLE physiopathology is controversial, and its relation with lupus nephritis is also discordant. ANCA could represent an important factor in the heterogeneity of systemic lupus erythematosus and lupus nephritis. SN - 1399-3046 UR - https://www.unboundmedicine.com/medline/citation/28133935/Post_transplant_immune_complex_nephritis_in_a_patient_with_systemic_lupus_erythematosus_associated_with_ANCA_vasculitis_ L2 - https://doi.org/10.1111/petr.12895 DB - PRIME DP - Unbound Medicine ER -