Document Detail

Immunohistological study of a pediatric patient with plasma cell-rich acute rejection.
MedLine Citation:
PMID:  22747477     Owner:  NLM     Status:  In-Data-Review    
We report here the case of a girl who developed plasma cell-rich acute rejection (PCAR), a condition characterized by the presence of mature plasma cells infiltrating a renal allograft. The patient's creatinine level increased sharply to 4.3 mg/dL from 0.9 mg/dL at 19 months post-renal transplantation. She showed no response to methylprednisolone pulse therapy at a dose of 500 mg for three d but did show an immediate clinical and histopathological response to muromonab-CD3 (OKT3) administration. She had two episodes of PCAR recurrence and subsequently lost her graft. She had no evidences of antibody-mediated rejection including C4d deposition in peritubular capillaries and donor-specific antibodies during the entire follow-up period. To elucidate the pathogenesis of PCAR, immunohistological examination of infiltrating cells was performed. CD3-positive cells infiltration seemed to be associated with the CD138-positive cells infiltration, and the number of CD3-positive cells was increased preceding PCAR recurrence. Additionally, a rapid decrease in the number of CD138-positive cells and CD3-positive cells following the OKT3 administration was observed. This case suggests that T-cell mediated immune mechanisms might play a role in the development of PCAR.
Hiroko Chikamoto; Noriko Sugawara; Yuko Akioka; Tomokazu Shimizu; Shigeru Horita; Kazuho Honda; Takahito Moriyama; Junki Koike; Yutaka Yamaguchi; Motoshi Hattori
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical transplantation     Volume:  26 Suppl 24     ISSN:  1399-0012     ISO Abbreviation:  Clin Transplant     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  54-7     Citation Subset:  IM    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Department of Pediatric Nephrology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
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