title: Acute Rejection of a Kidney Transplant in a Patient With Common Variable Immunodeficiency: A Case Report.
abstract: Common variable immunodeficiency is a primary immunodeficiency characterized by hypogammaglobulinemia and recurrent bacterial infections. We report a case of a 44-year-old male patient with end-stage renal disease and an established diagnosis of common variable immunodeficiency who underwent a living unrelated kidney transplant. He remained nearly infection free on maintenance immunoglobulin replacement. However, his posttransplant course was complicated by acute rejection that ultimately led to allograft loss. This case illustrates the challenge of transplantation in this patient population because of the delicate balance that must be achieved between maintaining adequate immunosuppression and minimizing the risk of infection.
authors.affiliation: Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: O
authors.initials: O
authors.lastname: Al Nimri
authors.affiliation: Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: A
authors.initials: A
authors.lastname: Rajput
authors.affiliation: Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: E
authors.initials: E
authors.lastname: Martinez
authors.affiliation: Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Fahrenholz
authors.affiliation: Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: P
authors.initials: P
authors.lastname: Paueksakon
authors.affiliation: Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: A
authors.initials: A
authors.lastname: Langone
authors.affiliation: Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: beatrice.p.concepcion@vanderbilt.edu.
authors.forename: B P
authors.initials: BP
authors.lastname: Concepcion
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications; D017074:Common Variable Immunodeficiency / Q000150:complications*; D006084:Graft Rejection / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents