Open AccessLeukocytoclastic Vasculitis Associated with Bortezomib Therapy
Author(s) -
Thiagarajan Raj Yashwanth,
R Vairakkani,
Nagalakshmi Dhanapal Srinivasaprasad,
S Sujith,
K Thirumalvalavan,
Mervin Edwin Fernando
Publication year - 2020
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.301178
Subject(s) - medicine , bortezomib , vasculitis , biopsy , creatinine , tacrolimus , gastroenterology , vomiting , surgery , renal function , transplantation , multiple myeloma , disease
A 28-year-old male, 10 years post live-related renal transplant with stable graft function of 1.4 mg/dL, presented with complaints of loss of appetite and vomiting for three days. On evaluation, he was found to have significant graft dysfunction with a creatinine of 10.3 mg/dL. He was initiated on hemodialysis in view of uremic gastrointestinal symptoms. Graft biopsy done revealed acute cell-mediated rejection BANFF IIB and diffuse C4d-positive antibody-mediated rejection. He was treated with intravenous methylprednisolone, therapeutic plasma exchange, and intravenous immunoglobulin therapy, following which his graft function improved gradually. He received multiple injections of bortezomib as a part of anti-rejection treatment protocol and developed peripheral neuropathy, leukocytoclastic vasculitis, and varicellosis. This case report is to highlight the unusual phenomenon of leukocytoclastic vasculitis in a post renal transplant setting secondary to bortezomib therapy.