Acute transplant glomerulopathy with monocyte rich infiltrate

被引:6
作者
Lenihan, Colin R. [1 ]
Tan, Jane C. [1 ]
Kambham, Neeraja [2 ]
机构
[1] Stanford Univ, Med Ctr, Div Nephrol, Dept Med, Stanford, CA 94305 USA
[2] Stanford Univ, Med Ctr, Dept Pathol, Stanford, CA 94305 USA
关键词
Acute transplant glomerulopathy; Transplant glomerulitis; Alemtuzumab; Monocyte; Macrophage; Kidney transplantation; ANTIBODY-MEDIATED REJECTION; RENAL-ALLOGRAFT REJECTION; CAPILLARY C4D DEPOSITION; HEPATITIS-C INFECTION; HUMORAL REJECTION; KIDNEY-TRANSPLANTATION; CELL-TYPES; BIOPSIES; GLOMERULITIS; CAMPATH-1H;
D O I
10.1016/j.trim.2013.09.004
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Acute transplant glomerulopathy refers to alloimmune mediated endothelial injury and glomerular inflammation that typically occurs early post-kidney transplantation. We report a case of a 48-year old woman with end stage renal disease from lupus nephritis who developed an unexplained rise in serum creatinine 2 months after renal transplant. As immunosuppression, she received alemtuzumab induction followed by a tacrolimus, mycophenolate mofetil and prednisone maintenance regimen. Her biopsy revealed severe glomerular endothelial injury associated with monocyte/macrophage-rich infiltrate in addition to mild acute tubulointerstitial cellular rejection. We briefly discuss acute transplant glomerulitis, its pathology and association with chronic/overt transplant glomerulopathy, C4d negative antibody-mediated rejection and the significance of monocytes in rejection. We also postulate that alemtuzumab induction may have contributed to the unusual pattern of monocyte-rich transplant glomerulitis. (C) 2013 Elsevier B.V. All rights reserved.
引用
收藏
页码:114 / 117
页数:4
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