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Am J Kidney Dis. 2005 Apr;45(4):758-61.

Pulmonary-renal syndrome in a newborn with placental transmission of ANCAs.

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Department of Medicine, Section of Nephrology, Rush University Medical Center, Chicago, IL, USA.

Erratum in

  • Am J Kidney Dis. 2005 Jul;46(1):171.


Despite clinical and experimental data suggesting a direct relationship between antineutrophil cytoplasmic antibodies (ANCAs) and disease activity in patients with microscopic polyangiitis (MPA), the causal relationship between perinuclear ANCAs specific for myeloperoxidase (MPO-ANCA) and disease manifestations has been controversial. We describe the case of a woman with a history of pulmonary-renal syndrome caused by MPA whose disease became clinically and serologically active during pregnancy. Forty-eight hours after delivery, the newborn developed pulmonary hemorrhage and abnormalities in renal function. The newborn's cord blood showed an immunoglobulin G MPO-ANCA level identical to that of the mother's serum, indicating passive transfer of the antibody to the neonate. Our findings represent the first human model supporting the interpretation that MPO-ANCAs were immunopathogenic.

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