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Asymptomatic post‐transplant lymphoproliferative disorder diagnosed at one year protocol renal allograft biopsy
Author(s) -
Kitajima Kazuki,
Sasaki Hideo,
Koike Junki,
Nakazawa Ryuto,
Sato Yuichi,
Yazawa Masahiko,
Tsuruoka Kayo,
Kawarazaki Hiroo,
Imai Naohiko,
Shirai Sayuri,
Shibagaki Yugo,
Chikaraishi Tatsuya
Publication year - 2014
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12246
Subject(s) - medicine , asymptomatic , post transplant lymphoproliferative disorder , renal transplant , biopsy , lymphoproliferative disorders , transplantation , surgery , lymphoma , rituximab
Abstract Post‐transplant lymphoproliferative disorder ( PTLD ) is a neoplastic complication with a potentially fatal outcome that develops as a consequence of immunosuppression, and is mainly associated with E pstein‐ B arr virus ( EBV ) infection. A 70‐year‐old woman underwent a live unrelated, ABO ‐incompatible renal transplant for end‐stage renal disease. One year after transplantation, protocol biopsy revealed pathological changes indicative of the histological subtype of ‘early lesions of PTLD ’ according to the W orld H ealth O rganization classification, while the patient showed no clinical signs or symptoms. The patient was finally diagnosed with EBV ‐positive PTLD by in situ hybridization for EBER ( EBV ‐encoded RNA ), and was successfully treated based on the reduction of immunosuppression. Protocol biopsy within the first post‐transplant year is the only diagnostic measure to detect asymptomatic early PTLD , which allows for early intervention and leads to better outcomes.