Successful treatment of central nervous system PTLD with rituximab and cranial radiotherapy.
Pediatr Nephrol
; 28(10): 2053-6, 2013 Oct.
Article
em En
| MEDLINE
| ID: mdl-23743853
ABSTRACT
BACKGROUND:
Primary central nervous system (PCNS) post-transplant lymphoproliferative disorder (PTLD) is a rare complication of solid organ transplantation and is typically an Epstein-Barr virus (EBV)-induced B-cell CD20+ lymphoma. The modalities of treatment include reduction in immunosuppression, cranial radiotherapy (CRT), intravenous and intrathecal rituximab when CD20 is expressed on B-lymphocytes and PTLD cells, and chemotherapy. CASE-DIAGNOSIS/TREATMENT We report the successful treatment of EBV-driven PCNS PTLD by reduction in immunosuppression (RI), CRT, and intravenous rituximab. Our patient was an 11-year-old boy with a living-related renal transplant for end-stage renal failure (ESRF) secondary to posterior urethral valves (PUV) and bilateral renal dysplasia (BRD) and on triple immunosuppression with prednisolone, tacrolimus, and azathioprine who had a rising EBV load, which was managed with reduction in tacrolimus dose, withdrawal of azathioprine, and introduction of mycophenolate mofetil (MMF).CONCLUSIONS:
The patient presented 7 years post-transplant with a seizure and abnormal neurology secondary to polymorphous hyperplastic lesions in the brain, which responded to rituximab and CRT.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Irradiação Craniana
/
Linfoma de Células B
/
Transplante de Rim
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Neoplasias do Sistema Nervoso Central
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Infecções por Vírus Epstein-Barr
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Anticorpos Monoclonais Murinos
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Quimiorradioterapia
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Falência Renal Crônica
/
Antineoplásicos
Tipo de estudo:
Diagnostic_studies
Limite:
Child
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article