Case report: Recurrence of anti-myeloperoxidase pauci-immune crescentic glomerulonephritis in a kidney transplant recipient; potential association with HLA antigens and seropositivity? - Scorecard - MDSpire

Case report: Recurrence of anti-myeloperoxidase pauci-immune crescentic glomerulonephritis in a kidney transplant recipient; potential association with HLA antigens and seropositivity?

  • By

  • Woojin James Chon

  • Choli Hartono

  • Elena-Rodica Vasilescu

  • David Serur

  • Ibrahim Batal

  • June 17, 2026

  • 0 min

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Clinical Scorecard: Case Study: Early Recurrence of Anti-Myeloperoxidase Pauci-Immune Crescentic Glomerulonephritis in a Kidney Transplant Patient; Possible Links to HLA Antigens and Antibody Presence

At a Glance

CategoryDetail
ConditionAnti-myeloperoxidase (anti-MPO) antineutrophil cytoplasmic antibodies-associated vasculitis (AAV)
Key MechanismsPauci-immune crescentic glomerulonephritis associated with elevated anti-MPO antibodies and permissive HLA antigens.
Target PopulationKidney transplant recipients with a history of anti-MPO AAV.
Care SettingPost-kidney transplantation.

Key Highlights

  • Early recurrence of anti-MPO AAV in kidney allograft is rare.
  • Potential links between HLA antigens and disease recurrence.
  • Elevated anti-MPO antibodies observed post-transplantation.
  • Patient treated with pulse steroids and Rituximab.
  • Monitoring for disease recurrence is crucial in at-risk patients.

Guideline-Based Recommendations

Diagnosis

  • Monitor anti-MPO antibody levels post-transplantation.
  • Conduct allograft biopsies in cases of elevated serum creatinine.

Management

  • Administer pulse steroids and Rituximab for recurrent disease.

Monitoring & Follow-up

  • Regular follow-up of serum creatinine and urine protein-to-creatinine ratio.

Risks

  • Increased risk of recurrence associated with shared HLA antigens.

Patient & Prescribing Data

Kidney transplant recipients with prior anti-MPO AAV.

Belatacept-based immunosuppression with monitoring for anti-MPO antibodies.

Clinical Best Practices

  • Close monitoring for signs of recurrence in patients with elevated anti-MPO antibodies.
  • Consider HLA typing in transplant candidates with a history of anti-MPO AAV.

Related Resources & Content

Original Source(s)

Case report: Recurrence of anti-myeloperoxidase pauci-immune crescentic glomerulonephritis in a kidney transplant recipient; potential association with HLA antigens and seropositivity?

  • by Woojin James Chon, Choli Hartono, Elena-Rodica Vasilescu, David Serur, Ibrahim Batal

  • June 17, 2026

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