title: [Epstein-Barr virus-associated posttransplant lymphoproliferative disease after renal transplantation].
abstract: A 24-year-old Japanese male was admitted to our hospital because of lymphadenopathy in his left neck. He had a nine-year history of chronic renal failure, and had received an ABO-mismatched renal allograft and splenectomy in August 2000 after one year of hemodialysis treatment. After renal transplantation, he was treated with FK506, methylprednisolone (mPSL), and mycophenolate mofetil (MMF) as an immunosuppressants for his graft maintenance. On admission, April 2001, he underwent lymphadenectomy, and the immunohistochemical studies revealed that the tumor cells expressed EBV-LMP and EBNA-2 antigens with the histology of diffuse large B-cell lymphoma. Our diagnosis was an Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disease (PTLD), and we reduced the dose of immunosuppressive agents and treated the patient with rituximab. In this case, there may have been two principal risk factors associated with PTLD: first, the patient was treated with higher levels of immunosuppressive agents because of the ABO-mismatched transplantation, and second, he was an EBV-seronegative recipient at the time of pretransplantation.
authors.affiliation: First Department of Internal Medicine, Ehime University School of Medicine, Ehime, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Matsubara
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yakushijin
authors.forename: Tetsuhiko
authors.initials: T
authors.lastname: Nomura
authors.forename: Kikue
authors.initials: K
authors.lastname: Iwamasa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Narumi
authors.forename: Ikuya
authors.initials: I
authors.lastname: Sakai
authors.forename: Masaki
authors.initials: M
authors.lastname: Yasukawa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Fujita
authors.forename: Takaaki
authors.initials: T
authors.lastname: Hato
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohshima
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Uno
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001787:Blood Group Incompatibility / Q000150:complications; D020031:Epstein-Barr Virus Infections / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000628:therapy; D008297:Male; D011183:Postoperative Complications; D000069283:Rituximab
chemical_list: D000017:ABO Blood-Group System; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab