Combination Treatment of Rituximab and Plasmapheresis in Acute Cellular Rejection with Focal Segmental Glomerular Sclerosis after Renal Transplantation / 대한이식학회지
The Journal of the Korean Society for Transplantation
; : 30-34, 2010.
Article
em Ko
| WPRIM
| ID: wpr-173700
Biblioteca responsável:
WPRO
ABSTRACT
Focal segmental glomerular sclerosis (FSGS) accounts for recurrence in 20% to 40% of the renal allografts after transplantation, and it causes graft loss in 13% to 20% of the cases. We report here on successfully treating acute cellular rejection (ACR) combined with FSGS after a kidney transplantation with a combination treatment of plasmapheresis, rituximab and steroid pulse therapy. A 53-year-old female patient whose primary kidney disease was unknown developed massive proteinuria after living donor kidney transplantation. A urine protein/creatinine ratio of 13.42 and an elevated serum creatinine level was detected on postoperative days (POD) 10 and a renal biopsy showed acute cellular rejection (Banff IIb) combined with FSGS. We started steroid pulse therapy on POD 11. She underwent 5 plasmapheresis sessions in the first 3 week after transplantation and she received one dose of rituximab (375 mg/m2) on POD 12. The proteinuria decreased below the nephrotic range at POD 20 and the serum creatinine level was normalized. Three months later, the proteinuria was at 35 mg/day with stable graft function. Rituximab and plasmapheresis is a possible option to treat FSGS combined with a relapse of proteinuria after renal transplantation.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Proteinúria
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Recidiva
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Rejeição em Psicologia
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Esclerose
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Transplante Homólogo
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Biópsia
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Transplante de Rim
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Plasmaferese
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Doadores Vivos
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Transplantes
Limite:
Female
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Humans
Idioma:
Ko
Ano de publicação:
2010
Tipo de documento:
Article