From immunosuppression to autoimmunity: PR3+ ANCA-associated vasculitis in a patient immunosuppressed for hepatic transplant. A case report

Vergara Serpa, Oscar Vicente; Velásquez-Franco, Carlos Jaime; Pinto, Luis Fernando; Charris, Neil Smith Pertuz; García, Andrés Felipe Echeverri; Palacio, Alejandro Cardona; Hernández, Javier Darío Márquez

doi:10.1016/j.rcreu.2024.05.005

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Revista Colombiana de Reumatología

Print version ISSN 0121-8123

Abstract

VERGARA SERPA, Oscar Vicente et al. From immunosuppression to autoimmunity: PR3+ ANCA-associated vasculitis in a patient immunosuppressed for hepatic transplant. A case report. Rev.Colomb.Reumatol. [online]. 2025, vol.32, n.3, pp.286-293. Epub May 08, 2026. ISSN 0121-8123. https://doi.org/10.1016/j.rcreu.2024.05.005.

Objective:

To present the case of an immunosuppressed patient who developed an autoimmune disease.

Patients and methods:

30-year-old woman, immunosuppressed due to a history of orthotopic liver transplant, who developed intestinal infection by cytomegalovirus and alveolar haemorrhage.

Results:

Patient presented a positive serological finding for PR3 ANCA, classified as granulomatosis with polyangiitis. Due to her history, induction, and maintenance with an anti-CD20 were considered, with no further relapse over 6-month follow-up.

Conclusion:

Immunosuppressed patients have risk factors for developing autoimmune diseases.

Keywords : Blood-air barrier; Cytomegalovirus; Granulomatosis with polyangiitis; Liver transplantation; ANCA-associated vasculitis.

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