Autoimmune haemolytic anaemia associated with Epstein Barr virus infection as a severe late complication after kidney transplantation and successful treatment with rituximab: case report

2.50
Hdl Handle:
http://hdl.handle.net/11287/594008
Title:
Autoimmune haemolytic anaemia associated with Epstein Barr virus infection as a severe late complication after kidney transplantation and successful treatment with rituximab: case report
Authors:
Hamilton, Alexander J.; Webb, Lynsey H.; Williams, Jennifer K.; D'Souza, Richard J.; Ngu, Loretta S.; Moore, Jason
Abstract:
BACKGROUND: Autoimmune haemolytic anaemia (AIHA) is a rare complication following kidney transplantation and usually occurs early in its course. It is characterised by autoantibodies or alloantibodies directed against red blood cells (RBCs). CASE PRESENTATION: We describe a 44 year old woman who presented 5 years after kidney transplantation with profound transfusion dependent warm AIHA. Investigations confirmed an IgG autoantibody against RBCs and high titre Epstein-Barr virus (EBV) viraemia. The patient was at higher risk for EBV disease being seronegative at the time of transplantation but had detectable EBV capsid IgG antibody at the time of presentation. The haemolysis was refractory to high dose steroid and intravenous immunoglobulin. There was a rapid and complete resolution of both the anaemia and the viraemia following rituximab therapy, with no adverse events. Twenty-six units of blood were required during the course of treatment. CONCLUSIONS: To our knowledge this is the first reported case of EBV associated AIHA in a renal transplant recipient. It highlights a rare pathology associated with post-transplant EBV infection, of broad interest to transplant physicians, haematologists, and microbiologists, and the effective novel use of monoclonal anti-CD20 therapy.
Citation:
BMC Nephrol. 2015 Jul 18;16:108.
Publisher:
BioMed Central
Journal:
BMC nephrology
Issue Date:
18-Jul-2015
URI:
http://hdl.handle.net/11287/594008
DOI:
10.1186/s12882-015-0096-3
PubMed ID:
26187383
Additional Links:
http://www.biomedcentral.com/1471-2369/16/108
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Journal Article
Language:
eng
ISSN:
1471-2369
Appears in Collections:
2015 RD&E publications; Exeter Kidney Unit (Renal)

Full metadata record

DC FieldValue Language
dc.contributor.authorHamilton, Alexander J.en
dc.contributor.authorWebb, Lynsey H.en
dc.contributor.authorWilliams, Jennifer K.en
dc.contributor.authorD'Souza, Richard J.en
dc.contributor.authorNgu, Loretta S.en
dc.contributor.authorMoore, Jasonen
dc.date.accessioned2016-01-19T12:38:32Zen
dc.date.available2016-01-19T12:38:32Zen
dc.date.issued2015-07-18en
dc.identifier.citationBMC Nephrol. 2015 Jul 18;16:108.en
dc.identifier.issn1471-2369en
dc.identifier.pmid26187383en
dc.identifier.doi10.1186/s12882-015-0096-3en
dc.identifier.urihttp://hdl.handle.net/11287/594008en
dc.description.abstractBACKGROUND: Autoimmune haemolytic anaemia (AIHA) is a rare complication following kidney transplantation and usually occurs early in its course. It is characterised by autoantibodies or alloantibodies directed against red blood cells (RBCs). CASE PRESENTATION: We describe a 44 year old woman who presented 5 years after kidney transplantation with profound transfusion dependent warm AIHA. Investigations confirmed an IgG autoantibody against RBCs and high titre Epstein-Barr virus (EBV) viraemia. The patient was at higher risk for EBV disease being seronegative at the time of transplantation but had detectable EBV capsid IgG antibody at the time of presentation. The haemolysis was refractory to high dose steroid and intravenous immunoglobulin. There was a rapid and complete resolution of both the anaemia and the viraemia following rituximab therapy, with no adverse events. Twenty-six units of blood were required during the course of treatment. CONCLUSIONS: To our knowledge this is the first reported case of EBV associated AIHA in a renal transplant recipient. It highlights a rare pathology associated with post-transplant EBV infection, of broad interest to transplant physicians, haematologists, and microbiologists, and the effective novel use of monoclonal anti-CD20 therapy.en
dc.language.isoengen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1471-2369/16/108en
dc.titleAutoimmune haemolytic anaemia associated with Epstein Barr virus infection as a severe late complication after kidney transplantation and successful treatment with rituximab: case reporten
dc.typeJournal Articleen
dc.identifier.journalBMC nephrologyen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en
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