Hashimoto's encephalopathy after intensive lymphocyte depletion with rabbit anti-thymocyte globulin in a renal transplant patient
| Autor: | D. M. Penn, C. B. Wakefield, Lucile E. Wrenshall, D. Alonso, R. B. Stevens, Jill Y. Skorupa, Theodore H. Rigley |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Population Encephalopathy Hashimoto's encephalopathy Hashimoto Disease Gastroenterology Lymphocyte Depletion Autoimmune thyroiditis Internal medicine medicine Immunology and Allergy Animals Humans Pharmacology (medical) education Kidney transplantation Antilymphocyte Serum Diabetic Coma Transplantation education.field_of_study business.industry Immunosuppression Middle Aged medicine.disease Kidney Transplantation Anti-thymocyte globulin Diabetes Mellitus Type 1 Immunology Female Rabbits business |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 8(1) |
| ISSN: | 1600-6143 |
| Popis: | There has been no reported case of Hashimoto's encephalopathy (HE) ('steroid-responsive encephalopathy associated with autoimmune thyroiditis', 'SREAT'), in the renal transplant recipient population. We describe the case of a 55-year-old female with Type-1 diabetes who presented 2 years posttransplantation in a comatose state that had developed over the preceding 24 h. The patient had received a short, intensive course of rATG induction at the time of transplantation and early steroid withdrawal. After 6 months she had been withdrawn from calcineurin inhibitors and was maintained on mycophenolate mofetil and sirolimus. Systematic workup determined the cause of her coma to be HE. High-dose steroid therapy resulted in complete resolution of the patient's symptoms. The literature regarding the diagnosis, course and treatment of HE is reviewed and the possibility that increased use of steroid-free immunosuppression and intensive lymphocyte depletion regimens may increase the prevalence of de novo autoimmune disease is discussed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text