Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3850314 | American Journal of Kidney Diseases | 2009 | 4 Pages |
Abstract
Myeloperoxidase (MPO)-specific antineutrophil cytoplasmic antibodies have been proposed as pathogenic for microscopic polyangiitis. Supporting this hypothesis, a case report of transplacental anti-MPO antibody transfer presumably causing a vasculitis-like syndrome in the newborn is cited frequently. Here, we report a case of transplacental transfer of high levels of anti-MPO antibodies not resulting in clinical compromise in the newborn. The mother developed microscopic polyangiitis 5 years before the pregnancy. After induction therapy, remission was maintained with low-dose prednisone and azathioprine for 4.5 years despite high levels of anti-MPO antibodies (>100 U/mL). The patient elected to become pregnant, immunosuppression was maintained during pregnancy, and a normal-term neonate was delivered. The newborn's venous blood anti-MPO antibody levels decreased gradually from greater than 100 U/mL at birth to undetectable by day 120. No clinical manifestation of vasculitis developed in the newborn. This case supports that anti-MPO antibodies alone are not pathogenic without additional cofactors.
Keywords
Related Topics
Health Sciences
Medicine and Dentistry
Nephrology
Authors
Francisco MD, Ulrich MD, Sanjeev MD, PhD, Maria Valentina MD, Fernando C. MD, PhD,