Pneumocystis jirovecii pneumonia after rituximab therapy for antibody-mediated rejection in a renal transplant recipient.
We report the case of a 54-year-old woman who underwent living-related renal transplantation for end-stage renal disease from IgA nephropathy. She was subsequently diagnosed with antibody-mediated rejection (AMR) and received rituximab, a potent B-cell suppressive agent. After therapy with rituximab, she developed Pneumocystis jirovecii pneumonia (PJP) requiring hospitalization. We discuss the increasing literature for the use of rituximab for AMR and the need for PJP prophylaxis in this setting.
Kumar
D
D
Transplant Infectious Diseases, Division of Infectious Diseases, University of Alberta, Edmonton, Alberta, Canada. deepali.kumar@ualberta.ca
Gourishankar
S
S
Mueller
T
T
Cockfield
S
S
Weinkauf
J
J
Vethanayagam
D
D
Humar
A
A
D000890:Anti-Infective Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D053626:Atovaquone / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D007275:Injections, Intravenous; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000000981:diagnostic imaging / Q000209:etiology*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000382:microbiology*; D011859:Radiography; D000069283:Rituximab; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D014295:Trimethoprim / Q000627:therapeutic use
D000890:Anti-Infective Agents; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab; D014295:Trimethoprim; D053626:Atovaquone