PTLD in a kidney receptor: case report

• Published in: Revista colombiana de nefrología (En línea) Vol. 4; no. 2; pp. 210 - 216
• Main Authors: Rodríguez-Sánchez, Martha Patricia, García-Padilla, Paola Karina, Contreras, Kateir Mariel, González-González, Camilo Alberto, Puentes, Sofía
• Format: Journal Article
• Language: Portuguese
• Published: Asociación Colombiana de Nefrología e Hipertensión Arterial 01-12-2017
• Subjects: SOCIAL SCIENCES, INTERDISCIPLINARY; lymphoproliferative disorders; trasplante renal; virus Epstein Barr; tituximab; kidney transplantation; rituximab; Epstein Barr Virus; trastornos linfoproliferativos
• ISSN: 2500-5006; 2500-5006
• DOI: 10.22265/acnef.4.2.218

Abstract Posttransplant Lymphoproliferative Disorders (PTLDs) occur in 3 to 10% of adults with solid organ transplant (SOT). It has been associated with Epstein Barr Virus (EBV) infection. Differential diagnostics of PTLD from rejection or viral infection is difficult when the tumor infiltrates the graft, because the clinical and histopathological findings are similar. We report a case of patient with chronic kidney disease due to Ig M glomerulonephritis with cadaveric donor kidney transplantation who presented proteinuria and decreased glomerular filtration rate, with a solid mass at renal graft and confirmatory histology of polymorphic renal transplant lymphoproliferative disorder (PTLD), VEB positive, and CD 20 positive. The patient was treated with rituximab 375 mg / m2 weekly, four doses, followed by chemotherapy with ciclophosphamide, vincristine and doxorubicin. He didn't need radiotherapy or graft nephrectomy, with complete remission at one year of follow-up and optimal graft function.