Document Detail

Leflunomide therapy for BK virus allograft nephropathy after pediatric kidney transplantation.
MedLine Citation:
PMID:  23210794     Owner:  NLM     Status:  Publisher    
The BK virus (BKV) can be reactivated with immunosuppressive treatment in renal allograft recipients, which can result in interstitial nephritis (BKV-associated nephropathy, BKVAN) and lead to renal allograft failure. Recently, leflunomide has been reported in some case series of BKVAN with favorable results. Most studies have included only adult patients, we herein report a pediatric case and include a literature review. The patient was a nine-yr-old female with end-stage renal disease due to hypoxic kidney injury. A deceased donor renal transplant was performed and good initial allograft function was achieved following treatment with prednisolone, tacrolimus and mycophenolate mofetil. The serum Cr level increased to 1.6 mg/dL over the following four-month period. A kidney biopsy revealed pathologic findings of acute cellular rejection and BK nephropathy. After methylprednisolone pulse therapy was administered to control acute rejection, the tacrolimus dose was reduced, and intravenous immunoglobulin treatment and leflunomide therapy were administered to control the BKVAN. Over the following 18 months, the viral load steadily decreased and remained below 100 copies/mL in the plasma. Leflunomide therapy in addition to a reduction of the immunosuppressive therapies resulted in a significant decline in the BK viral load without further deterioration of renal function.
Young H Jung; Kyung C Moon; Jong W Ha; Sang-Joon Kim; Il-Soo Ha; Hae I Cheong; Hee G Kang
Related Documents :
10086964 - Common variant in ampd1 gene predicts improved clinical outcome in patients with heart ...
23979854 - Fulminant hepatitis due to human adenovirus.
24460584 - Disseminated adenovirus infection in kidney transplant recipient.
170384 - Phagocytic capability of the kidney: a possible mechanism for renal uptake of colloid i...
17910654 - Growth curves of pediatric patients with biliary atresia following living donor liver t...
8689104 - Quantitative assessment of vascular surface density in renal cell carcinomas.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-4
Journal Detail:
Title:  Pediatric transplantation     Volume:  -     ISSN:  1399-3046     ISO Abbreviation:  Pediatr Transplant     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9802574     Medline TA:  Pediatr Transplant     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Implant-supported full-arch zirconia-based mandibular fixed dental prostheses. Eight-year results fr...
Next Document:  The utility of the 'temporary marginal lid suture' in facilitating Mohs surgery for tumours involvin...