Bk Polyoma Virus Nephropathy In An Immunocompromised Host.

Background: Post-transplant Lymphopoliferative disorders(PTLD) are a well known late complication after solid organ transplantation including renal transplant. Among others, graft failure due to reactivation of BK polyoma virus in the grafted kidney is also a well recognized complication but tends to present early in the first several months after transplant. Case: Here we present the case of PTLD Burkitt's lymphoma(BL-PTLD) in a renal transplant patient who was successfully treated with multiagent chemo-immunotherapy but later developed BK polyoma virus nephropathy(BKVN) with graft failure only after completion of her systemic therapy for lymphoma and 7 years after transplant. Relevant literature is reviewed. Conclusion: In this case, reactivation and progression of BKVN was most likely associated with immunosuppression from chemoimmunotherapy for her BL–PTLD unlike early graft failures associated with BKVN.

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Reinforcing the Immunocompromised Host Defense against Fungi: Progress beyond the Current State of the Art

Journal of Fungi ◽

10.3390/jof7060451 ◽

2021 ◽

Vol 7 (6) ◽

pp. 451

Author(s):

Georgios Karavalakis ◽

Evangelia Yannaki ◽

Anastasia Papadopoulou

Keyword(s):

Host Defense ◽

Hematopoietic Cell Transplantation ◽

State Of The Art ◽

Fungal Infections ◽

Solid Organ Transplantation ◽

Immunocompromised Host ◽

Antifungal Drugs ◽

Solid Organ ◽

Cell Immunotherapy ◽

Life Threatening

Despite the availability of a variety of antifungal drugs, opportunistic fungal infections still remain life-threatening for immunocompromised patients, such as those undergoing allogeneic hematopoietic cell transplantation or solid organ transplantation. Suboptimal efficacy, toxicity, development of resistant variants and recurrent episodes are limitations associated with current antifungal drug therapy. Adjunctive immunotherapies reinforcing the host defense against fungi and aiding in clearance of opportunistic pathogens are continuously gaining ground in this battle. Here, we review alternative approaches for the management of fungal infections going beyond the state of the art and placing an emphasis on fungus-specific T cell immunotherapy. Harnessing the power of T cells in the form of adoptive immunotherapy represents the strenuous protagonist of the current immunotherapeutic approaches towards combating invasive fungal infections. The progress that has been made over the last years in this field and remaining challenges as well, will be discussed.

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Transplantation

Oxford Handbook of Clinical Immunology and Allergy ◽

10.1093/med/9780198789529.003.0015 ◽

2019 ◽

pp. 399-414

Author(s):

Gavin Spickett

Keyword(s):

Gene Therapy ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Organ Transplantation ◽

Cell Transplantation ◽

Graft Failure ◽

Solid Organ Transplantation ◽

Solid Organ ◽

Graft Vs Host Disease ◽

The Subject

This chapter covers the indications, methods, immunological considerations, and monitoring of various types of transplantation. Covering stem cell transplantation, gene therapy, graft vs host disease, graft failure, and solid organ transplantation, the chapter provides an immunological overview of the subject.

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Diagnosis of Polyoma Virus Infection In Renal Transplant Recipients

Microscopy and Microanalysis ◽

10.1017/s1431927600019152 ◽

1999 ◽

Vol 5 (S2) ◽

pp. 1166-1167

Author(s):

J. A. C. King ◽

D. N. Howell ◽

J. A. Tucker ◽

R. P. Lowry

Keyword(s):

Renal Transplant ◽

Virus Infection ◽

Renal Transplant Patient ◽

Bk Virus ◽

Polyoma Virus ◽

Immunosuppressed Patient ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Immunosuppressed Patients ◽

Cadaver Kidney

BK polyoma virus is a 40-45 nm DNA virus that was first identified in the urine of an immunosuppressed patient in 1971. BK virus infection often occurs in childhood and is subclinical. The majority of adults have antibodies to the virus. Asymptomatic viruria, ureteral ulceration, and ureteral stenosis have been described with infection in immunosuppressed patients. Renal graft dysfunction and interstitial nephritis have been associated with BK virus. Differentiation between rejection and infection is important. We report a case of a renal transplant patient with BK polyoma virus infection. This case illustrates the variety of methods that can be used for identification of BK polyoma virus.The patient, a 52 year old female, presented with an asymptomatic rise in serum creatinine (1.4 to 2.1 mg/dl). Her past medical history was significant for a cadaver kidney transplant two years prior for polycystic kidney disease.

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Gastrointestinal Mucormycosis in a Renal Transplant Patient

Canadian Journal of Gastroenterology ◽

10.1155/2001/237384 ◽

2001 ◽

Vol 15 (4) ◽

pp. 269-271 ◽

Cited By ~ 14

Author(s):

Jill Tinmouth ◽

Jeffrey Baker ◽

Geoffrey Gardiner

Keyword(s):

Renal Transplant ◽

Renal Transplant Patient ◽

Transplant Patient ◽

Clinical Course ◽

Organ Transplant ◽

Pathological Examination ◽

Solid Organ ◽

Resected Tissue ◽

Solid Organ Transplant Patient ◽

Organ Transplant Patient

The clinical course and management of a rare case of gastrointestinal mucormycosis occurring in a renal transplant patient are presented. The diagnosis was made on pathological examination of surgically resected tissue from the colon, spleen and stomach. The patient did not survive the infection. To the best of our knowledge, this is the 11th reported case of gastrointestinal mucormycosis in a solid organ transplant patient. The pathophysiology, incidence and prognosis of this disease are discussed.

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T-cell post-transplantation lymphoproliferative disorder, a rare and challenging late complication of solid organ transplantation

Pediatric Transplantation ◽

10.1111/j.1399-3046.2008.00915.x ◽

2008 ◽

Vol 12 (6) ◽

pp. 617-618 ◽

Cited By ~ 2

Author(s):

Zeinab Afify

Keyword(s):

T Cell ◽

Organ Transplantation ◽

Lymphoproliferative Disorder ◽

Late Complication ◽

Solid Organ Transplantation ◽

Solid Organ ◽

Post Transplantation

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Acquisition of Isochromosome 7 Is a Late Change in the Pathogenesis of Hepatosplenic Lymphoma, Documented On a Case of Adolescent Girl 5 Years After Renal Transplant with Preceding TCR Gamma-Delta Positive LGL Leukemia.

Blood ◽

10.1182/blood.v114.22.5031.5031 ◽

2009 ◽

Vol 114 (22) ◽

pp. 5031-5031

Author(s):

Ester Mejstrikova ◽

Edita Kabickova ◽

David Sumerauer ◽

Tomas Seeman ◽

Eva Fronkova ◽

...

Keyword(s):

T Cells ◽

Renal Transplant ◽

Conflicts Of Interest ◽

Residual Disease ◽

Solid Organ Transplantation ◽

Gamma Delta T Cells ◽

Solid Organ ◽

Gamma Delta ◽

Hepatosplenic Lymphoma ◽

Isochromosome 7Q

Abstract Abstract 5031 Background Post-transplant lymphoproliferative disorders (PTLD) occur in 1-20% of recipients receiving solid organ transplantation. We describe a patient who suffered from hepatosplenic T-cell lymphoma occurring after previous PTLD in a renal transplant recipient. Patient/Methods An 11-yr-old girl underwent kidney transplantation for end-stage Fanconi's nephronophthisis in 2002. In October 2006 significant neutropenia (<200/uL) was firstly detected, without any abnormality in bone marrow (BM) aspirate and without hepato- or splenomegaly. Episodes of neutropenia resolved spontaneously or after enhanced immunosuppression and G-CSF. In January 2007 new episodes of neutropenia and newly significant “monocytosis” were detected in peripheral blood (PB) and BM. Percentage of “monocytes” corresponded with immunophenotypically atypical TCR gamma/delta positive T cells (CD7weakposCD5negCD3bright) in PB and BM. Clonal TCR gamma and delta rearrangements were identified which enabled qPCR minimal residual disease (MRD) assessment. No lymphadenopathy was present, slight hepatosplenomegaly was identified by sonography. Conventional and molecular cytogenetic analyses didn't reveal any chromosomal aberration in PB and BM including changes on chromosome 7. No increased levels of EBV and CMV load by PCR were found. Partial increase of granulocytes and slight decrease of atypical TCR gamma/delta T cells were detected after administration of corticosteroid bolus and mercaptopurin. Three months later she presented with fever, rapidly progressive hepatosplenomegaly and pancytopenia, clinically corresponding with hepatosplenic lymphoma. At this time, newly acquired isochromosome 7q was detected by FISH. Results Initial therapy with campath and fludarabine was ineffective. She didn't respond to the 2nd line treatment (prednisone, vincristine, daunorubicine,asparaginase) and died 2 weeks later from lymphoma progression. Autopsy identified severe hemophagocytosis in the liver. Retrospectively, we identified identical clonal TCR rearrangements in the PB samples from March 2006 (∼0.03% of lymphoma PB MRD level), when neither changes in PB count nor clinical symptoms were found. Conclusion We detected a “pre-lymphoma” phase with clonal expansion of atypical TCR gamma/delta T cells more than 1 year before lymphoma manifestation. The presence of isochromosome 7q was a late change during this lymphoma genesis. Grant support IGA NS/9997-4; IGA NR/9531-3, IGA NS 10480-3, Research Projects MZCR 000064203, MSM0021620813 Disclosures No relevant conflicts of interest to declare.

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BK polyoma virus infection and renal disease in non-renal solid organ transplantation

Clinical Kidney Journal ◽

10.1093/ckj/sfv143 ◽

2015 ◽

Vol 9 (2) ◽

pp. 310-318 ◽

Cited By ~ 12

Author(s):

Sarat Kuppachi ◽

Deepkamal Kaur ◽

Danniele G. Holanda ◽

Christie P. Thomas

Keyword(s):

Virus Infection ◽

Renal Disease ◽

Organ Transplantation ◽

Solid Organ Transplantation ◽

Polyoma Virus ◽

Solid Organ

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Trichodysplasia spinulosa in a renal transplant patient: A case report of successful treatment

SAGE Open Medical Case Reports ◽

10.1177/2050313x20953039 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2095303

Author(s):

Camille Pennou ◽

Eileen Javidi ◽

Julie Lecours ◽

Annie Bélisle ◽

Sandra Davar

Keyword(s):

Case Report ◽

Renal Transplant ◽

Transplant Recipient ◽

Immunosuppressive Therapy ◽

Kidney Transplant ◽

Renal Transplant Patient ◽

Transplant Patient ◽

Kidney Transplant Recipient ◽

Solid Organ ◽

Immunocompromised Patients

Trichodysplasia spinulosa is a rare cutaneous disease caused by the trichodysplasia spinulosa–associated polyomavirus. It occurs more frequently in immunocompromised patients, particularly in solid organ transplants. A few successful treatments have been described in the literature. In our report, we present a biopsy-proven trichodysplasia spinulosa case in a kidney transplant recipient who rapidly responded to a reduction of his immunosuppressive therapy.

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Pyomyositis bij een niertransplantatiepatiënt na het doormaken van een diepe veneuze trombose

Tijdschrift voor Geneeskunde ◽

10.47671/tvg.77.21.140 ◽

2021 ◽

Author(s):

D. VAN LINTHOUT ◽

P. DOUBEL

Keyword(s):

Venous Thromboembolism ◽

Renal Transplant ◽

Renal Transplant Patient ◽

Transplant Patient ◽

Relevant Literature ◽

Delayed Diagnosis ◽

Recent Experience ◽

The Past ◽

Intravenous Antibiotics ◽

Tropical Areas

Pyomyositis in a renal transplant patient after experiencing a venous thromboembolism Pyomyositis is a bacterial infection of skeletal muscle tissue that results in localized abscess formation. In the past this disease was endemic to tropical areas, but in recent decades the number of cases in temperate climates has been increasing. The diagnosis is difficult and often delayed. Diagnosis can be made by MRI. Treatment consists of surgery and intravenous antibiotics. In this case report a 75-year-old renal transplant patient was diagnosed with pyomyositis after experiencing a venous thromboembolism (VTE). Despite the rarity of this syndrome, pyomyositis is more often described in the relevant literature than one would expect. Confounding factors in this case were the recent experience of VTE, as well as an existing lumboischialgia; risk factors were the immunosuppressive status, diabetes mellitus and the recent VTE. Noteworthy with this case of pyomyositis was the atypical germ and muscle group. Finally, the further course of the disease in this case made clear that the possible side effects of a therapy should always be considered when starting treatment.

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