1. Immunohistological study of a pediatric patient with plasma cell-rich acute rejection.
- Author
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Chikamoto, Hiroko, Sugawara, Noriko, Akioka, Yuko, Shimizu, Tomokazu, Horita, Shigeru, Honda, Kazuho, Moriyama, Takahito, Koike, Junki, Yamaguchi, Yutaka, and Hattori, Motoshi
- Subjects
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KIDNEY transplantation , *COMPLICATIONS from organ transplantation , *GRAFT rejection , *PLASMA cells , *METHYLPREDNISOLONE , *HOMOGRAFTS , *IMMUNOHISTOCHEMISTRY , *PEDIATRIC therapy - Abstract
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. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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