Asymptomatic post-transplant lymphoproliferative disorder diagnosed at one year protocol renal allograft biopsy.
Post-transplant lymphoproliferative disorder (PTLD) is a neoplastic complication with a potentially fatal outcome that develops as a consequence of immunosuppression, and is mainly associated with Epstein-Barr virus (EBV) infection. A 70-year-old woman underwent a live unrelated, ABO-incompatible renal transplant for end-stage renal disease. One year after transplantation, protocol biopsy revealed pathological changes indicative of the histological subtype of 'early lesions of PTLD' according to the World Health Organization classification, while the patient showed no clinical signs or symptoms. The patient was finally diagnosed with EBV-positive PTLD by in situ hybridization for EBER (EBV-encoded RNA), and was successfully treated based on the reduction of immunosuppression. Protocol biopsy within the first post-transplant year is the only diagnostic measure to detect asymptomatic early PTLD, which allows for early intervention and leads to better outcomes.
Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan.
Kazuki
K
Kitajima
Hideo
H
Sasaki
Junki
J
Koike
Ryuto
R
Nakazawa
Yuichi
Y
Sato
Masahiko
M
Yazawa
Kayo
K
Tsuruoka
Hiroo
H
Kawarazaki
Naohiko
N
Imai
Sayuri
S
Shirai
Yugo
Y
Shibagaki
Tatsuya
T
Chikaraishi
D000368:Aged; D058070:Asymptomatic Diseases; D001706:Biopsy; D020031:Epstein-Barr Virus Infections / Q000209:etiology / Q000473:pathology*; D005260:Female; D004854:Herpesvirus 4, Human; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000473:pathology* / Q000821:virology*; D014184:Transplantation, Homologous
Epstein-Barr virus; post-transplant lymphoproliferative disorder (PTLD); renal allograft biopsy