Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature

Despite the benefits of the immunosuppressive medications to improve the graft function, they present several adverse effects, such as development of post-transplant lymphoproliferative disorder in renal transplant recipients needing sometime a drastic reduction or withdrawal of the Immunosuppressio...

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Autores: Pádua Netto , Marcus Vinícius de, Lima , Henrique Vieira de, Costa , Émerson Nunes, Pádua Netto, Luiz Cláudio, Borges , Ana Paula de Souza, Santos , Eduardo Moreira dos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2007
País:Brasil
Institución:Associação Brasileira de Transplante de Órgãos (ABTO)
Repositorio:Brazilian Journal of Transplantation
Idioma:portugués
OAI Identifier:oai:ojs3.emnuvens.com.br:article/335
Acceso en línea:https://bjt.emnuvens.com.br/revista/article/view/335
Access Level:acceso abierto
Palabra clave:Transplante Renal
Transtornos Linfoproliferativos
Sirolimo
Imunosupressão
Kidney Transplantation
Lymphoproliferative Disorders
Sirolimus
Imunosupression
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spelling Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literatureDOENÇA LINFOPROLIFERATIVA PÓS-TRANSPLANTE TRATADA COM RITUXIMAB E SIROLIMUS: RELATO DE CASO E REVISÃO DA LITERATURATransplante RenalTranstornos LinfoproliferativosSirolimoImunosupressãoKidney TransplantationLymphoproliferative DisordersSirolimusImunosupressionDespite the benefits of the immunosuppressive medications to improve the graft function, they present several adverse effects, such as development of post-transplant lymphoproliferative disorder in renal transplant recipients needing sometime a drastic reduction or withdrawal of the Immunosuppression and the consequent risk for graft rejection. We report a 20-year-old white man with chronic renal failure diagnosis secondary to Plune Belly Syndrome that started hemodialisys therapy in 2004, and after six months, his mother offered to donate a kidney to him; he was treated with Tacrolimus, Mofetil Mycophenolate and Prednisone. Four months later, a post-transplant lymphoproliferative diagnosis was made, and the Tacrolimus and Mofetil Mycophenoplate were suddenly discontinued. There was no response, and Rituximab was associated, when the computed tomography showed regression of splenomegaly and remission of the lymphadenomegaly. Based on the benefit reported in the literature, Sirolimus was associated to Prednisone in the Immunosuppression maintenance.Apesar dos benefícios do uso de imunossupressores para prevenir perda do enxerto no transplante renal, eles apresentam vários efeitos colaterais, entre eles as doenças linfoproliferativas que levam, por vezes, à necessidade de redução ou até mesmo da retirada total das drogas imunossupressoras, com risco de rejeição ao enxerto. Relatamos um caso de um paciente branco, 20 anos, portador de insuficiência renal crônica secundária à Síndrome de Prune Belly, tendo iniciado hemodiálise em 2004, e, após seis meses, submetido a transplante renal e mantida imunossupressão com Tacrolimus, Micofenolato mofetil e Prednisona. No quarto mês pós-transplante renal desenvolveu quadro de doença linfoproliferativa pós-transplante, sendo então retirados imediatamente o Tacrolimus e Micofenolato mofetil, mantido apenas com Prednisona. Após aproximadamente um mês da retirada da imunossupressão, como não houve boa resposta com a redução da imunossupressão associada à terapia antiviral, optamos pela associação de Rituximab ao tratamento, com acompanhamento através de tomografia computadorizada, mostrando remissão total da esplenomegalia e da linfadenomegalia. Baseados em dados da literatura, foi associado Sirolimo à imunossupressão do paciente e mantida Prednisona com boa evolução após dois anos de seguimento.Associação Brasileira de Transplante de Órgãos (ABTO)2007-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://bjt.emnuvens.com.br/revista/article/view/33510.53855/bjt.v10i2.335Brazilian Journal of Transplantation; Vol. 10 No. 2 (2007); 733-737Brazilian Journal of Transplantation; v. 10 n. 2 (2007); 733-7372764-1589reponame:Brazilian Journal of Transplantationinstname:Associação Brasileira de Transplante de Órgãos (ABTO)instacron:ABTOporhttps://bjt.emnuvens.com.br/revista/article/view/335/313Copyright (c) 2021 Brazilian Journal of Transplantationinfo:eu-repo/semantics/openAccessPádua Netto , Marcus Vinícius deLima , Henrique Vieira deCosta , Émerson NunesPádua Netto, Luiz CláudioBorges , Ana Paula de SouzaSantos , Eduardo Moreira dos2021-09-28T14:20:43Zoai:ojs3.emnuvens.com.br:article/335Revistahttps://bjt.emnuvens.com.br/revistaONGhttps://bjt.emnuvens.com.br/revista/oaibjt@abto.org.brhttps://doi.org/10.53855/2764-15892764-1589opendoar:2021-09-28T14:20:43Brazilian Journal of Transplantation - Associação Brasileira de Transplante de Órgãos (ABTO)false
dc.title.none.fl_str_mv Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature
DOENÇA LINFOPROLIFERATIVA PÓS-TRANSPLANTE TRATADA COM RITUXIMAB E SIROLIMUS: RELATO DE CASO E REVISÃO DA LITERATURA
title Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature
spellingShingle Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature
Pádua Netto , Marcus Vinícius de
Transplante Renal
Transtornos Linfoproliferativos
Sirolimo
Imunosupressão
Kidney Transplantation
Lymphoproliferative Disorders
Sirolimus
Imunosupression
title_short Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature
title_full Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature
title_fullStr Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature
title_full_unstemmed Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature
title_sort Post-transplant lymphoproliferative disorder treated with rituximab and sirolimus: case report and review of literature
dc.creator.none.fl_str_mv Pádua Netto , Marcus Vinícius de
Lima , Henrique Vieira de
Costa , Émerson Nunes
Pádua Netto, Luiz Cláudio
Borges , Ana Paula de Souza
Santos , Eduardo Moreira dos
author Pádua Netto , Marcus Vinícius de
author_facet Pádua Netto , Marcus Vinícius de
Lima , Henrique Vieira de
Costa , Émerson Nunes
Pádua Netto, Luiz Cláudio
Borges , Ana Paula de Souza
Santos , Eduardo Moreira dos
author_role author
author2 Lima , Henrique Vieira de
Costa , Émerson Nunes
Pádua Netto, Luiz Cláudio
Borges , Ana Paula de Souza
Santos , Eduardo Moreira dos
author2_role author
author
author
author
author
dc.subject.por.fl_str_mv Transplante Renal
Transtornos Linfoproliferativos
Sirolimo
Imunosupressão
Kidney Transplantation
Lymphoproliferative Disorders
Sirolimus
Imunosupression
topic Transplante Renal
Transtornos Linfoproliferativos
Sirolimo
Imunosupressão
Kidney Transplantation
Lymphoproliferative Disorders
Sirolimus
Imunosupression
description Despite the benefits of the immunosuppressive medications to improve the graft function, they present several adverse effects, such as development of post-transplant lymphoproliferative disorder in renal transplant recipients needing sometime a drastic reduction or withdrawal of the Immunosuppression and the consequent risk for graft rejection. We report a 20-year-old white man with chronic renal failure diagnosis secondary to Plune Belly Syndrome that started hemodialisys therapy in 2004, and after six months, his mother offered to donate a kidney to him; he was treated with Tacrolimus, Mofetil Mycophenolate and Prednisone. Four months later, a post-transplant lymphoproliferative diagnosis was made, and the Tacrolimus and Mofetil Mycophenoplate were suddenly discontinued. There was no response, and Rituximab was associated, when the computed tomography showed regression of splenomegaly and remission of the lymphadenomegaly. Based on the benefit reported in the literature, Sirolimus was associated to Prednisone in the Immunosuppression maintenance.
publishDate 2007
dc.date.none.fl_str_mv 2007-03-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://bjt.emnuvens.com.br/revista/article/view/335
10.53855/bjt.v10i2.335
url https://bjt.emnuvens.com.br/revista/article/view/335
identifier_str_mv 10.53855/bjt.v10i2.335
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://bjt.emnuvens.com.br/revista/article/view/335/313
dc.rights.driver.fl_str_mv Copyright (c) 2021 Brazilian Journal of Transplantation
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2021 Brazilian Journal of Transplantation
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Associação Brasileira de Transplante de Órgãos (ABTO)
publisher.none.fl_str_mv Associação Brasileira de Transplante de Órgãos (ABTO)
dc.source.none.fl_str_mv Brazilian Journal of Transplantation; Vol. 10 No. 2 (2007); 733-737
Brazilian Journal of Transplantation; v. 10 n. 2 (2007); 733-737
2764-1589
reponame:Brazilian Journal of Transplantation
instname:Associação Brasileira de Transplante de Órgãos (ABTO)
instacron:ABTO
instname_str Associação Brasileira de Transplante de Órgãos (ABTO)
instacron_str ABTO
institution ABTO
reponame_str Brazilian Journal of Transplantation
collection Brazilian Journal of Transplantation
repository.name.fl_str_mv Brazilian Journal of Transplantation - Associação Brasileira de Transplante de Órgãos (ABTO)
repository.mail.fl_str_mv bjt@abto.org.br
_version_ 1853663433432498176
score 15,300719

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