Graft rupture after high-dose intravenous immunoglobulin therapy in a renal transplant patient.
Cases of life-threatening thromboses in pulmonary, coronary, cerebral and peripheral vessels are associated with high-dose intravenous immunoglobulin (IVIg) therapy that is generally considered safe. We experienced a patient with a renal graft rupture that developed after high-dose IVIg was administered for desensitization. A needle biopsy performed 4 days prior to the rupture revealed the presence of glomerular thrombosis and mesangiolysis. The ruptured nephrectomy specimen contained renal infarction around the haemorrhagic segment and arterial wall thickening with intimal fibrosis. This might have contributed to rupturing associated with small arterial and glomerular arteriolar thrombi. This is the first case of a graft rupture as a complication of high-dose IVIg we have encountered.
Division of Nephrology, Department of Internal Medicine, Bong Seng Hospital, Busan, South Korea.
Yong-Hun
YH
Sin
Yong-Jin
YJ
Kim
Joon Seok
JS
Oh
Jin Ho
JH
Lee
Seong Min
SM
Kim
Joong Kyung
JK
Kim
D004306:Dose-Response Relationship, Immunologic; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D012422:Rupture, Spontaneous; D013923:Thromboembolism / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D014184:Transplantation, Homologous
D016756:Immunoglobulins, Intravenous
allograft rupture; complication; focal segmental glomerulosclerosis; high-dose intravenous immunoglobulin therapy; thromboembolism; transplantation