Acute Graft-Versus-Host-Disease in Kidney Transplantation: Case Report and Review of Literature
| Autor: | Koji Yazawa, Keigo Madono, Taigo Kato, Kiichiro Itoh, Masahiro Hosomi, Jun Saito |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Reoperation Hemolytic anemia Anemia Hemolytic Anemia medicine.medical_treatment Anti-Inflammatory Agents Graft vs Host Disease chemical and pharmacologic phenomena HLA Antigens immune system diseases Biopsy medicine Humans Methylprednisolone Hemisuccinate Kidney transplantation Transplantation medicine.diagnostic_test business.industry Immunosuppression Bacterial Infections Mycophenolic Acid medicine.disease Kidney Transplantation Rash Anti-Bacterial Agents Treatment Outcome surgical procedures operative Graft-versus-host disease Acute Disease Immunology Female Surgery Pancreas Transplantation medicine.symptom business Immunosuppressive Agents |
| Zdroj: | Transplantation Proceedings. 41:3949-3952 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2009.05.030 |
| Popis: | Graft-versus-host-disease (GVHD) is a complication of solid organ transplantation, most commonly of the small bowel or liver. Herein, we have presented a case of GVHD in a 27-year-old man who underwent an human leukocyte antigen (HLA) minor mismatch renal transplantation from his father. After the procedure, the patient presented with a fever, skin rash, and watery diarrhea. An allograft kidney biopsy demonstrated no sign of rejection; however, anti-A antibody was detected in plasma and progressive anemia was attributed to hemolytic anemia owing to a passenger lymphocyte syndrome. From those findings, we suspected that the clinical symptoms were caused by acute GVHD. An endoscopic biopsy of the colon revealed apoptotic cells consistent with the disease. We found reports of only 5 other GVHD cases after kidney transplantation. Several risk factors are associated with GVHD, such as transfer of graft lymphocytes, donor HLA homozygosity, and a relationship between recipient immunogenicity and immunosuppression. In this case, detection led to early diagnosis of donor-derived GVHD due to passenger lymphocyte syndrome. It is important keep GVHD in mind and to understand its risk factors as the mortality rate is high. |
| Databáze: | OpenAIRE |
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