Abstract |
Posttransplant lymphoproliferative disorder (PTLD) remains one of the most important complications of intensive immunosuppressive therapy. A 65-year-old Caucasian woman received a primary en bloc kidney transplant from a deceased 2-year-old donor. After antithymocyte globulin induction she was treated with a maintenance regimen including cyclosporine and mycophenylate mofetil (MMF). She had a history of recurrent dermatomyositis, suggesting a flawed immune system. After a benign course for 9 months and after an increase in MMF from 2 to 3 g daily, she presented with pneumonia owing to Candida albicans, which was responsive to antibiotics, as was the PTLD. Persistent fever led to a diagnosis of PTLD. The immunosuppressive regimen was converted to sirolimus (SRL) and rituximab, with over 90% necrosis of the neoplasm at 1 month. However, owing to concern at exploration, the allografts were extirpated. This case documented the benefit of the rituximab-SRL combination to treat PTLD while maintaining dermatomyositis in remission.
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Authors | Z Kaposztas, W B Etheridge, B D Kahan |
Journal | Transplantation proceedings
(Transplant Proc)
Vol. 40
Issue 5
Pg. 1744-6
(Jun 2008)
ISSN: 0041-1345 [Print] United States |
PMID | 18589184
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Murine-Derived
- Immunosuppressive Agents
- Rituximab
- Sirolimus
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Topics |
- Aged
- Antibodies, Monoclonal
(therapeutic use)
- Antibodies, Monoclonal, Murine-Derived
- Appendectomy
- Child, Preschool
- Dermatomyositis
(drug therapy, surgery)
- Female
- Humans
- Immunosuppressive Agents
(adverse effects, therapeutic use)
- Kidney Function Tests
- Kidney Transplantation
(adverse effects, immunology, physiology)
- Lymphoproliferative Disorders
(drug therapy)
- Ovariectomy
- Postoperative Complications
(drug therapy)
- Rituximab
- Sirolimus
(therapeutic use)
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