Recurrence of anti-GBM disease 8 years after renal transplantation
Recurrence of anti-GBM disease 8 years after renal transplantation
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DOI：
10.1093/ndt/gfg393
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发表时间：
2004-02-01
影响因子：
6.1
通讯作者：
Cattran, DC
中科院分区：
文献类型：
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作者：
Khandelwal, M;McCormick, BB;Cattran, DC
抗肾小球基底膜（GBM）疾病是以针对在GBM上发现的IV型胶原的表位的抗体为特征的病症。主要的临床后遗症是快速进行性肾小球肾炎，可伴有肺出血（肺出血综合征）。在肾功能明显受损的患者亚组中，继发于抗GBM疾病的肾小球肾炎经常进展为终末期肾病（ESRD）。由于抗GBM疾病，对ESRD进行肾移植，尽管大多数中心延迟移植，直到患者抗GBM抗体阴性至少12个月。虽然早期病例系列显示同种异体移植物中经常复发[1]，但现代治疗方法使复发性疾病非常罕见，仅报告了4例[2-5]。对复发性同种异体移植物疾病的治疗效果还没有很好的描述。我们报告一例移植肾复发性抗GBM疾病并成功挽救移植肾的病例。
Anti-glomerular basement membrane (GBM) disease is a disorder characterized by antibodies against an epitope of type IV collagen found on the GBM. The major clinical sequela is rapidly progressive glomerulonephritis, which may be accompanied by pulmonary haemorrhage (Goodpasture’s syndrome). Glomerulonephritis secondary to anti-GBM disease frequently progresses to end-stage renal disease (ESRD) in the subset of patients who present with markedly impaired renal function. Renal transplantation is performed for ESRD due to anti-GBM disease, although most centres delay transplantation until patients are anti-GBM antibody negative for at least 12 months. Although early case series showed frequent recurrence in the allograft [1], modern therapeutic approaches have made recurrent disease very rare, and only four cases have been reported [2–5]. The effect of therapy for recurrent allograft disease is not well described. We report a case of recurrent anti-GBM disease in a renal allograft with successful salvage of the allograft.