caa a22 4500 445883766 CHVBK 20180317145553.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10157-010-0387-8 doi (NATIONALLICENCE)springer-10.1007/s10157-010-0387-8 Rituximab in the treatment of acute cellular rejection of renal allograft with CD20-positive clusters in the infiltrate [Elektronische Daten] [Jorge Vega, Helmuth Goecke, Alejandra Carrasco, Carlos Escobar, Max Escobar, Roberto Espinosa, Gonzalo Méndez, María de los Ángeles Rodríguez] A 31-year-old woman with nephronophthisis received a cadaveric kidney transplant, and was immunosuppressed with cyclosporine, azathioprine and steroids. Twelve days after transplant a biopsy showed acute rejection with vascular damage. She was treated with 3 pulses of methylprednisolone and change of immunosuppression to mycophenolate mofetil and tacrolimus, without improving graft function. At day 21, a second biopsy showed accentuation of interstitial and vascular rejection. Antibody-mediated rejection was suspected and plasmapheresis and rituximab were prescribed. Graft function improved rapidly. Staining for C4d was negative and there were no circulating antibodies against the donor. In the interstitial infiltrate there were clusters of B lymphocytes that accounted for 40% of cells, which was thought to be an ominous sign, as it has been associated with poor graft outcome. Acute T-cell-mediated rejection grade III (Banff 07) was diagnosed. Thirty-nine months after transplant her kidney function is stable with no other complication. This clinical case generates the hypothesis that rituximab may have a beneficial role in the therapy of acute cellular rejection when there are clusters of B lymphocytes in the infiltrate and a good response has not been obtained to conventional anti-rejection therapy. Japanese Society of Nephrology, 2010 Kidney transplantation nationallicence Rituximab nationallicence Mycophenolate nationallicence Acute rejection nationallicence B lymphocytes nationallicence Treatment nationallicence Prognosis nationallicence Vega Jorge Departamento de Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaiso, Chile aut Goecke Helmuth Departamento de Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaiso, Chile aut Carrasco Alejandra Servicio de Medicina, Sección Nefrología, Hospital Naval Almirante Nef, 5 Norte, 1035, Viña del Mar, Chile aut Escobar Carlos Servicio de Urología, Hospital Naval Almirante Nef, Viña del Mar, Chile aut Escobar Max Servicio de Urología, Hospital Naval Almirante Nef, Viña del Mar, Chile aut Espinosa Roberto Servicio de Anatomía Patológica, Hospital Naval Almirante Nef, Viña del Mar, Chile aut Méndez Gonzalo Departamento de Patología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile aut de los Ángeles Rodríguez María Servicio de Hemato-Oncología, Hospital Naval Almirante Nef, Viña del Mar, Chile aut Clinical and Experimental Nephrology Springer Japan 15/2(2011-04-01), 308-311 1342-1751 15:2<308 2011 15 10157 https://doi.org/10.1007/s10157-010-0387-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-010-0387-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vega Jorge Departamento de Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaiso, Chile aut NATIONALLICENCE 700 1- Goecke Helmuth Departamento de Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaiso, Chile aut NATIONALLICENCE 700 1- Carrasco Alejandra Servicio de Medicina, Sección Nefrología, Hospital Naval Almirante Nef, 5 Norte, 1035, Viña del Mar, Chile aut NATIONALLICENCE 700 1- Escobar Carlos Servicio de Urología, Hospital Naval Almirante Nef, Viña del Mar, Chile aut NATIONALLICENCE 700 1- Escobar Max Servicio de Urología, Hospital Naval Almirante Nef, Viña del Mar, Chile aut NATIONALLICENCE 700 1- Espinosa Roberto Servicio de Anatomía Patológica, Hospital Naval Almirante Nef, Viña del Mar, Chile aut NATIONALLICENCE 700 1- Méndez Gonzalo Departamento de Patología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile aut NATIONALLICENCE 700 1- de los Ángeles Rodríguez María Servicio de Hemato-Oncología, Hospital Naval Almirante Nef, Viña del Mar, Chile aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/2(2011-04-01), 308-311 1342-1751 15:2<308 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer