| B-cell dysfunction and depletion using mycophenolate mofetil in a pediatric combined liver and kidney graft recipient. | |
| | |
MedLine Citation:
|
PMID: 11260491 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The use of mycophenolate mofetil (MMF) in combination with cyclosporin A (CsA) and steroids is well established after kidney transplantation (Tx) in children. A 9-yr-old girl with primary hyperoxaluria type 1 and systemic oxalosis underwent a combined kidney and liver Tx at our institution. The post-operative immunosuppression consisted of CsA, prednisolone, and MMF. Four weeks post-transplant the girl suffered from a severe urinary tract infection caused by Pseudomonas aeruginosa, when the serum immunoglobulin G (IgG) concentration was found to be critically low (<1.53 g/L). Additionally, there was an isolated B-cell depletion (240/microL) at that time. In the following course, the B-cell count was significantly diminished until the MMF was stopped 13 weeks post-transplant. As a result of the very low serum IgG concentration, intravenous immunoglobulin (IVIG) substitution was necessary. There was no significant loss of immunoglobulins in the ascites and urine and no other medication with possible side-effects on B cells was given. We suggest that MMF can lead to suppressed IgG production by B cells and can cause a defective differentiation into mature B cells. In vitro studies demonstrated these effects of MMF on B cells, but no in vivo cases of this phenomenon have been reported. B-cell counts and serum IgG concentrations returned to normal values after discontinuing the MMF. As we can assume that the observed B-cell dysfunction and depletion were MMF related, we suggest that serum IgG concentrations should be monitored when MMF is used after solid-organ Tx. |
| | |
Authors:
|
R Ganschow; M Lyons; M J Kemper; M Burdelski |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Pediatric transplantation Volume: 5 ISSN: 1397-3142 ISO Abbreviation: Pediatr Transplant Publication Date: 2001 Feb |
Date Detail:
|
Created Date: 2001-03-30 Completed Date: 2001-05-10 Revised Date: 2013-05-29 |
Medline Journal Info:
|
Nlm Unique ID: 9802574 Medline TA: Pediatr Transplant Country: Denmark |
Other Details:
|
Languages: eng Pagination: 60-3 Citation Subset: IM |
Affiliation:
|
Department of Pediatrics, University of Hamburg, Germany. ganschow@uke.uni-hamburg.de |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
B-Lymphocytes
/
drug effects*,
immunology Child Cyclosporine / adverse effects Female Graft Rejection / drug therapy Humans Immunocompromised Host Immunosuppressive Agents / adverse effects* Kidney Transplantation / immunology* Liver Transplantation / immunology* Mycophenolic Acid / adverse effects*, analogs & derivatives* Prednisolone / adverse effects Pseudomonas aeruginosa Urinary Tract Infections / etiology |
| Chemical | |
Reg. No./Substance:
|
0/Immunosuppressive Agents; 24280-93-1/Mycophenolic Acid; 50-24-8/Prednisolone; 59865-13-3/Cyclosporine; 9242ECW6R0/mycophenolate mofetil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Portal vein phlebolithiasis found post-liver transplantation in the native liver of a child with bil...
Next Document: Thoracoabdominal bypass graft with liver retransplantation for the treatment of a pseudoaneurysm of ...