Limits of clinical signs and non-invasive techniques in detecting severe acute rejection.
We describe a cadaveric renal transplant patient with an early post-transplant period characterized by normal urine output, normal clinical and biological signs, and a slow decrease of serum creatinine; repeated ultrasonography, color doppler ultrasonography and renal angioscintigraphy were normal or consistent with a clinical diagnosis of mild acute tubular necrosis. Nevertheless a core renal biopsy revealed severe steroid-resistant acute rejection with diffuse infiltrates of lymphocytes and initial transmural arteritis.
Bertoni
E
E
Renal Unit, Ospedale di Careggi, Firenze, Italy.
Di Maria
L
L
Piperno
R
R
Zanazzi
M
M
Rosati
A
A
Moscarelli
L
L
Salvadori
M
M
D000208:Acute Disease; D006084:Graft Rejection / Q000175:diagnosis*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity