Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Nov 6, 2016; 5(6): 547-550
Published online Nov 6, 2016. doi: 10.5527/wjn.v5.i6.547
Antineutrophil cytoplasmic antibodies crescentic allograft glomerulonephritis after sofosbuvir therapy
Shilpa Gadde, Belinda Lee, Laura Kidd, Rubin Zhang
Shilpa Gadde, Belinda Lee, Laura Kidd, Rubin Zhang, Department of Nephrology and Hypertension, Tulane University School of Medicine, New Orleans, LA 70112, United States
Author contributions: Gadde S, Lee B and Kidd L contributed to the acquisition of data and writing; Zhang R contributed to the writing and revision of this manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Tulane University School of Medicine in New Orleans.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rubin Zhang, MD, FASN, Professor of Medicine, Department of Nephrology and Hypertension, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA 70112, United States. rzhang@tulane.edu
Telephone: +1-504-9881457 Fax: +1-504-9887510
Received: June 15, 2016
Peer-review started: June 21, 2016
First decision: July 27, 2016
Revised: August 5, 2016
Accepted: October 5, 2016
Article in press: October 9, 2016
Published online: November 6, 2016
Processing time: 140 Days and 15.8 Hours
Abstract

Antineutrophil cytoplasmic antibodies (ANCA) are well known to be associated with several types of vasculitis, including pauci-immune crescentic glomerulonephritis, a form of rapid progressive glomerular nephritis (RPGN). ANCA vasculitis has also been reported after administration of propylthiouracil, hydralazine, cocaine (adulterated with levimasole), allopurinol, penicillamine and few other drugs. All previously reported cases of drug-associated ANCA glomerulonephritis were in native kidneys. Sofosbuvir is a new and effective drug for hepatitis C virus infection. Here, we report a case of ANCA vasculitis and RPGN following sofosbuvir administration in a kidney transplant recipient. It also represents the first case of drug-associated ANCA vasculitis in a transplanted kidney. Further drug monitoring is necessary to elucidate the degree of association and possible causal effect of sofosbuvir and perinuclear ANCA vasculitis.

Keywords: Crescentic glomerulonephritis; Vasculitis; Antineutrophil cytoplasmic antibody; Sofosbuvir; Kidney transplant

Core tip: Antineutrophil cytoplasmic antibodies (ANCA) vasculitis is well known to be associated with several drugs, including propylthiouracil, hydralazine, cocaine, levimasole and others. All previous cases of drug-associated ANCA glomerulonephritis were in native kidneys. Here, we report a case of ANCA vasculitis following sofosbuvir administration in a kidney transplant recipient. It is also the first case of drug-associated ANCA vasculitis in a transplanted kidney. Further drug monitoring is necessary to elucidate the degree of association and possible causal effect of sofosbuvir and perinuclear ANCA vasculitis.