TY - JOUR
T1 - Alloantigen-specific response is preserved and autoimmunity is maintained in an HIV-positive patient with immunoglobulin A nephropathy undergoing renal transplantation
T2 - A warning about long-term reduction in immunosuppression-A case report
AU - Morales, J.
AU - Alba, A.
AU - Espinoza, R.
AU - Sepúlveda, C.
AU - Contreras, L.
AU - Buckel, E.
AU - Noriega, L.
AU - Fierro, J. A.
PY - 2011/7
Y1 - 2011/7
N2 - We report the case of a 43-year-old patient with HIV infection treated with antiretroviral therapy, which was complicated by immunoglobulin A (IgA) nephropathy and renal failure, who subsequently was transplanted using a deceased donor kidney transplant. During the late posttransplant period we detected specific anti-donor HLA antibodies showing a preserved alloantigen response. A renal biopsy showed no acute cellular or humoral rejection, an absence of pericapillary C4d deposits or SV40 infected cells, but demonstrated IgA mesangial deposits and mild interstitial fibrosis probably related to calcineurin inhibitor toxicity. This case shows that allo- and autoimmune responses are preserved despite immunosuppressive treatment and original HIV disease. It warns of the importance of maintaining optimal monitoring and immunosuppressive strategies among HIV-positive recipients who become solid organ transplant recipients.
AB - We report the case of a 43-year-old patient with HIV infection treated with antiretroviral therapy, which was complicated by immunoglobulin A (IgA) nephropathy and renal failure, who subsequently was transplanted using a deceased donor kidney transplant. During the late posttransplant period we detected specific anti-donor HLA antibodies showing a preserved alloantigen response. A renal biopsy showed no acute cellular or humoral rejection, an absence of pericapillary C4d deposits or SV40 infected cells, but demonstrated IgA mesangial deposits and mild interstitial fibrosis probably related to calcineurin inhibitor toxicity. This case shows that allo- and autoimmune responses are preserved despite immunosuppressive treatment and original HIV disease. It warns of the importance of maintaining optimal monitoring and immunosuppressive strategies among HIV-positive recipients who become solid organ transplant recipients.
UR - http://www.scopus.com/inward/record.url?scp=80051695208&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2011.06.004
DO - 10.1016/j.transproceed.2011.06.004
M3 - Article
C2 - 21839266
AN - SCOPUS:80051695208
VL - 43
SP - 2341
EP - 2343
JO - Transplantation Proceedings
JF - Transplantation Proceedings
SN - 0041-1345
IS - 6
ER -