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논문분류	춘계학술대회 초록집
제목	A Case Report of Recurrent Henoch-Schonlein Purpura With Crescentic Glomerulonephritis in Renal Transplant Patient
저자	Jeong-myung Ahn
출판정보	2025; 2025(1):
키워드	recurrent GN, HSP, IgA nephropathy , post KT
초록	Recurrent Henoch-Schönlein purpura (HSP) after kidney transplantation is uncommon. It is reported with varying recurrent rates. We report a case and an effective management for recurrent HSP in a renal transplant patient. A 63-year-old female patient was admitted to our hospital complaining of abdominal pain, diarrhea and multiple purpura on her lower legs. She had donated her kidney to her family member, 27 years ago in another hospital. After 11 years of her donation, she suddenly had nephrotic syndrome, but she didn't have any diagnostic biopsy procedure because of her donation. Six years later she started hemodialysis, 7 years later she eventually had a DDKT(deceased donor kidney transplantation) in our hospital. After 4 years of having received the DDKT, she had the previously described symptoms and was admitted. Since she had a family history of the renal disease, we clinically had a suspicious HS purpura, we tried to increase the dose of oral steroid for control of her symptoms. Initially her symptoms seemed to be improving, but she continuously complained of intermittent abdominal pain. We also found that the urine protein-to-creatinine ratio was increasing on her urinalysis. So we decided on the 1st renal biopsy for her. Using the 1st biopsy, she was diagnosed with crescentic IgA nephropathy. After a steroid pulse therapy, we found her symptoms relieved and her laboratory abnormality(U-PCR) was improving. As she suddenly had a gross hematuria 6 months later, she had another renal biopsy(2nd). On her pathologic finding, she still had HSP with interstitial fibrosis and tubular atrophy(grade 1). As her renal disease activity was still continuing, we chose another immunosuppressant, pulsing rituximab and adding mycophenolate mofetil. After adding the immunosuppressant, her laboratory abnormality was totally improved. We report a recurrent HSP in renal transplanted patients.
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