[Double filtration plasma pheresis was effective on the recurrence of pulmonary hemorrhage after renal transplantation: report of a case].
A 35-year old female with an autoimmune disease complaining of recurrent hemoptysis and macrohematuria had received a renal transplantation from her mother. After transplantation, recurrence of pulmonary hemorrhage occurred twice. First recurrence followed the peritonitis with ileal perforation. Steroid pulse therapy had no effect on this recurrence, while double filtration plasmapheresis was effective. During this treatment, renal function was not failed. Second recurrence followed acute rejection that was cured with the OKT3-rescue therapy. DFPP therapy was effective on this episode. Pulmonary hemorrhage was caused by auto immune reaction and acute rejection caused by transplant immune reaction were recognized independently, and they needed different treatment. According to this clinical course, we consider the relation between auto immune reaction and transplant immune reaction was as follows. T cell activation caused by primary transplant immune reaction may have no direct influence on auto immune reaction. Peritonitis and rejection may induce auto immune reaction. We suppose that this auto immune reaction was caused by humoral factor, because auto immune reaction was controlled by DFPP.
Sekihara
T
T
Department of Urology, Osaka University School.
Jiang
H
H
Takahara
S
S
Kokado
Y
Y
Kameoka
H
H
Ishibashi
M
M
Sonoda
T
T
D000328:Adult; D001327:Autoimmune Diseases / Q000628:therapy*; D005260:Female; D006084:Graft Rejection; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D016030:Kidney Transplantation; D008171:Lung Diseases / Q000628:therapy*; D010956:Plasmapheresis / Q000379:methods*; D012008:Recurrence; D014181:Transplantation Immunology