Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant Patient
Lymphomatoid granulomatosis (LYG) in renal transplant recipients is rare multisystemic angiocentric lymphoproliferative disorder with significant malignant potential. Here, we describe LYG in a 70-year-old renal allograft recipient who, 4 years after transplantation, on tacrolimus and mycophenolate...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2011/865957 |
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| author | Cindy Castrale Wael El Haggan Françoise Chapon Oumedaly Reman Thierry Lobbedez Jean Philippe Ryckelynck Bruno Hurault de Ligny |
| author_facet | Cindy Castrale Wael El Haggan Françoise Chapon Oumedaly Reman Thierry Lobbedez Jean Philippe Ryckelynck Bruno Hurault de Ligny |
| author_sort | Cindy Castrale |
| collection | DOAJ |
| description | Lymphomatoid granulomatosis (LYG) in renal transplant recipients is rare multisystemic angiocentric lymphoproliferative disorder with significant malignant potential. Here, we describe LYG in a 70-year-old renal allograft recipient who, 4 years after transplantation, on tacrolimus and mycophenolate mofetil and prednisone maintenance immunosuppression, complained of low-grade fever, persistent headache and gait disturbance. The MRI of the brain revealed diffuse periventricular cerebral and cerebellar contrast-enhanced lesions. The CT scan of the thorax showed multiple pulmonary nodular opacities in both lung fields. The patient was diagnosed LYG based on the cerebral biopsy showing perivascular infiltration of CD20-positive B-lymphocytes with granulomatous lesions and immunofluorescence staining with anti-EBV antibodies. With careful reduction of the immunossuppression combined with the use of rituximab, our patient showed a complete disappearance of LYG, and she is clinically well more than 4 years after the diagnosis, with good kidney function. No recurrence has been observed by radiological imaging until now. This is the first report of a durable (>4 years) complete remission of LYG after treatment with rituximab in renal transplantation. |
| format | Article |
| id | doaj-art-fb01f3c5e6b34bc0bce1af981f80d8ed |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-fb01f3c5e6b34bc0bce1af981f80d8ed2025-02-03T00:59:51ZengWileyJournal of Transplantation2090-00072090-00152011-01-01201110.1155/2011/865957865957Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant PatientCindy Castrale0Wael El Haggan1Françoise Chapon2Oumedaly Reman3Thierry Lobbedez4Jean Philippe Ryckelynck5Bruno Hurault de Ligny6Department of Nephrology and Renal Transplantation, Caen University Hospital, 14033 Caen, FranceDepartment of Nephrology and Renal Transplantation, Caen University Hospital, 14033 Caen, FranceLaboratory of Pathology, Caen University Hospital, 14033 Caen, FranceDepartment of Clinical Hematology, Caen University Hospital, 14033 Caen, FranceDepartment of Nephrology and Renal Transplantation, Caen University Hospital, 14033 Caen, FranceDepartment of Nephrology and Renal Transplantation, Caen University Hospital, 14033 Caen, FranceDepartment of Nephrology and Renal Transplantation, Caen University Hospital, 14033 Caen, FranceLymphomatoid granulomatosis (LYG) in renal transplant recipients is rare multisystemic angiocentric lymphoproliferative disorder with significant malignant potential. Here, we describe LYG in a 70-year-old renal allograft recipient who, 4 years after transplantation, on tacrolimus and mycophenolate mofetil and prednisone maintenance immunosuppression, complained of low-grade fever, persistent headache and gait disturbance. The MRI of the brain revealed diffuse periventricular cerebral and cerebellar contrast-enhanced lesions. The CT scan of the thorax showed multiple pulmonary nodular opacities in both lung fields. The patient was diagnosed LYG based on the cerebral biopsy showing perivascular infiltration of CD20-positive B-lymphocytes with granulomatous lesions and immunofluorescence staining with anti-EBV antibodies. With careful reduction of the immunossuppression combined with the use of rituximab, our patient showed a complete disappearance of LYG, and she is clinically well more than 4 years after the diagnosis, with good kidney function. No recurrence has been observed by radiological imaging until now. This is the first report of a durable (>4 years) complete remission of LYG after treatment with rituximab in renal transplantation.http://dx.doi.org/10.1155/2011/865957 |
| spellingShingle | Cindy Castrale Wael El Haggan Françoise Chapon Oumedaly Reman Thierry Lobbedez Jean Philippe Ryckelynck Bruno Hurault de Ligny Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant Patient Journal of Transplantation |
| title | Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant Patient |
| title_full | Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant Patient |
| title_fullStr | Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant Patient |
| title_full_unstemmed | Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant Patient |
| title_short | Lymphomatoid Granulomatosis Treated Successfully with Rituximab in a Renal Transplant Patient |
| title_sort | lymphomatoid granulomatosis treated successfully with rituximab in a renal transplant patient |
| url | http://dx.doi.org/10.1155/2011/865957 |
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