[Early-onset antibody-mediated rejection with fever as the main manifestation after bilateral lung transplantation: a case report].

X Y Cui, B Wang, Q Y Zhan, M Liu, W H Chen
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引用次数: 0

Abstract

Antibody-mediated rejection (AMR) is a recognized cause of allograft dysfunction in lung transplant recipients due to the presence of donor-specific anti-human leukocyte antigen (HLA) antibodies (DSAs). Here, we reported that a 69-year-old woman with underlying connective tissue disease-associated interstitial lung disease (CTD-ILD) developed recurrent fever with elevated white blood cells, C-reactive protein (CRP) and new ground-glass opacities on chest computed tomography (CT) early after double lung transplantation. After a thorough investigation for infection, rejection and relapse of primary immune diseases, the patient was found to be panel-reactive antibody (PRA) positive and DSAs positive. Pathology of the transbronchial lung biopsy (TBLB) revealed positive histology suggestive of AMR and positive C4d staining. The final diagnosis was definite clinical AMR. Following treatment with plasma exchange and intravenous immunoglobulin (IVIg) infusion, the patient's condition improved significantly, and the patient was discharged from hospital.

[双侧肺移植术后以发热为主要表现的早发性抗体介导排斥反应1例]。
由于供体特异性抗人白细胞抗原(HLA)抗体(dsa)的存在,抗体介导的排斥反应(AMR)是公认的肺移植受者同种异体移植物功能障碍的原因。在这里,我们报道了一名患有结缔组织病相关间质性肺病(CTD-ILD)的69岁女性,双肺移植后早期出现复发性发热,白细胞、c反应蛋白(CRP)升高,胸部计算机断层扫描(CT)上出现新的磨玻璃样混浊。经过对感染、排斥反应和原发免疫疾病的彻底调查,患者发现PRA阳性,dsa阳性。经支气管肺活检(TBLB)病理显示AMR阳性组织学和C4d染色阳性。最终诊断为临床AMR。经血浆置换和静脉注射免疫球蛋白治疗后,患者病情明显好转,出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
3.50
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0.00%
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13832
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