ANCA +ve vasculitis after autologous PBSC transplantation

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Abstract
Acute renal failure (ARF) occurs frequently after bone marrow transplantation (BMT) and has ominous prognostic significance [1]. Sepsis, drug nephrotoxicity, veno‐occlusive disease of the liver, haemolytic uraemic syndrome (HUS) and acute and chronic graft‐versus‐host‐disease (GVHD) are important aetiological factors and post‐transplant ARF is often multifactorial. HUS, which can occur independently of GVHD or cyclosporin use, should be considered when ARF occurs more than 6 months after transplantation and may present as an acute nephritic illness [1]. In patients presenting with chest signs or symptoms and ARF after BMT or peripheral blood stem cell transplant (PBSCT), sepsis dominates the differential diagnosis. We present the case of a recipient of an autologous PBSCT who presented with pulmonary and renal manifestations of a small vessel vasculitis more than 2 years after transplantation.