Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant Patient

Lymphomatoid granulomatosis (LYG) in renal transplant recipients is rare multisystemic angiocentric lymphoproliferative disorder with significant malignant potential. Here, we describe LYG in a 70-year-old renal allograft recipient who, 4 years after transplantation, on tacrolimus and mycophenolate...

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Vydané v:Journal of Transplantation Ročník 2011; číslo 2011; s. 386 - 390
Hlavní autori: El Haggan, Wael, Castrale, Cindy, Chapon, Françoise, Reman, Oumedaly, Lobbedez, Thierry, Ryckelynck, Jean Philippe, Hurault de Ligny, Bruno
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Cairo, Egypt Hindawi Limiteds 01.01.2011
Hindawi Puplishing Corporation
Hindawi Publishing Corporation
Wiley
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Case Report
ISSN:2090-0007, 2090-0015, 2090-0015
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Shrnutí:Lymphomatoid granulomatosis (LYG) in renal transplant recipients is rare multisystemic angiocentric lymphoproliferative disorder with significant malignant potential. Here, we describe LYG in a 70-year-old renal allograft recipient who, 4 years after transplantation, on tacrolimus and mycophenolate mofetil and prednisone maintenance immunosuppression, complained of low-grade fever, persistent headache and gait disturbance. The MRI of the brain revealed diffuse periventricular cerebral and cerebellar contrast-enhanced lesions. The CT scan of the thorax showed multiple pulmonary nodular opacities in both lung fields. The patient was diagnosed LYG based on the cerebral biopsy showing perivascular infiltration of CD20-positive B-lymphocytes with granulomatous lesions and immunofluorescence staining with anti-EBV antibodies. With careful reduction of the immunossuppression combined with the use of rituximab, our patient showed a complete disappearance of LYG, and she is clinically well more than 4 years after the diagnosis, with good kidney function. No recurrence has been observed by radiological imaging until now. This is the first report of a durable (>4 years) complete remission of LYG after treatment with rituximab in renal transplantation.
Bibliografia:ObjectType-Case Study-2
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Academic Editor: Bernhard K. Krämer
ISSN:2090-0007
2090-0015
2090-0015
DOI:10.1155/2011/865957