Abstract：
BACKGROUND: Kidney transplantation is an acceptable therapy end-stage kidney disease secondary to antineutrophil cytoplasmic antibody-associated vasculitis with risk of disease recurrence ranging from 3% to 17%. Standard posttransplant immunosuppression is the mainstay of therapy after recurrence. Recently, new medications focused on complement regulation and avoidance of steroids have been shown to be effective in treating antineutrophil cytoplasmic antibody (ANCA) vasculitis with no studies in the pediatric population.
METHODS: We report a 5-year-old patient with immediate recurrence of positive myeloperoxidase (MPO)-ANCA vasculitis after deceased donor kidney transplant and the novel use of eculizumab to salvage the graft.
RESULTS: Eculizumab and transition to ravulizumab has been successful in improving graft function and maintenance of disease remission after immediate MPO-ANCA vasculitis recurrence posttransplant.
CONCLUSIONS: Complement inhibitors may be used in addition to standard immunosuppression postkidney transplant in a pediatric patient with MPO-ANCA vasculitis recurrence without higher rates of infections.
METHODS: We report a 5-year-old patient with immediate recurrence of positive myeloperoxidase (MPO)-ANCA vasculitis after deceased donor kidney transplant and the novel use of eculizumab to salvage the graft.
RESULTS: Eculizumab and transition to ravulizumab has been successful in improving graft function and maintenance of disease remission after immediate MPO-ANCA vasculitis recurrence posttransplant.
CONCLUSIONS: Complement inhibitors may be used in addition to standard immunosuppression postkidney transplant in a pediatric patient with MPO-ANCA vasculitis recurrence without higher rates of infections.
摘要：
背景：肾移植是一种可接受的治疗终末期肾病继发于抗中性粒细胞胞浆抗体相关性血管炎，疾病复发风险在3%至17%之间。标准移植后免疫抑制是复发后治疗的主要手段。最近,针对补体调节和避免使用类固醇的新药已被证明可有效治疗抗中性粒细胞胞浆抗体(ANCA)血管炎,但尚未在儿科人群中进行研究.
方法：我们报告了一名5岁患者，在已死亡的供体肾脏移植后，髓过氧化物酶（MPO）-ANCA血管炎阳性立即复发，并新使用依库珠单抗挽救移植物。
结果：Eculizumab和过渡到ravulizumab在移植后MPO-ANCA血管炎立即复发后成功改善移植物功能和维持疾病缓解。
结论：对于MPO-ANCA血管炎复发且无较高感染率的儿科患者，除了标准的肾移植后免疫抑制外，还可以使用补体抑制剂。
方法：我们报告了一名5岁患者，在已死亡的供体肾脏移植后，髓过氧化物酶（MPO）-ANCA血管炎阳性立即复发，并新使用依库珠单抗挽救移植物。
结果：Eculizumab和过渡到ravulizumab在移植后MPO-ANCA血管炎立即复发后成功改善移植物功能和维持疾病缓解。
结论：对于MPO-ANCA血管炎复发且无较高感染率的儿科患者，除了标准的肾移植后免疫抑制外，还可以使用补体抑制剂。
