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Preserved Endocrine Function in a Pancreas Transplant Recipient with Pancreatic Panniculitis and Antibody‐Mediated Rejection
Author(s) -
Prikis M.,
Norman D.,
Rayhill S.,
Olyaei A.,
Troxell M.,
Mittalhenkle A.
Publication year - 2010
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2010.03332.x
Subject(s) - medicine , pancreas transplantation , pancreas , endocrine system , transplantation , biopsy , antibody , pathology , diabetes mellitus , acute pancreatitis , immunology , kidney transplantation , endocrinology , hormone
Pancreas transplantation is an effective treatment option for patients with complicated diabetes mellitus. Pancreas allograft recipients are followed with laboratory markers such as serum amylase, lipase and glucose levels. Hyperglycemia may indicate severe acute rejection and has recently been associated with antibody‐mediated (humoral) rejection. In this report, we describe a unique case of a pancreas‐after‐kidney (PAK) transplant recipient with the rare presentation of pancreatic panniculitis, biopsy‐proven severe acute cellular and antibody‐mediated pancreas allograft rejection and surprisingly well‐preserved endocrine function despite treatment with high dose steroids. We discuss the clinicopathologic features of antibody‐mediated pancreas rejection, including the importance of correlating pancreas allograft biopsy, C4d staining and donor specific antibodies, to diagnose antibody‐mediated rejection and initiate the correct treatment.