Angiotensin II type 1 receptor antibody precipitating acute vascular rejection in kidney transplantation
Atypical non HLA antibodies are increasingly recognised as causes of immunological injury in allotransplantation. In this report we describe a non HLA sensitized male renal allograft recipient who developed acute vascular rejection on a “for cause” biopsy (Banff v2, g2, ptc 3) at day 4 post first re...
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| Veröffentlicht in: | Nephrology (Carlton, Vic.) Vic.), 2015-03, Vol.20 (S1), p.10-12 |
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| container_title | Nephrology (Carlton, Vic.) |
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| creator | Jobert, Anjelo Rao, Nitesh Deayton, Sue Bennett, Greg D Brealey, John Nolan, James Carroll, Robert P Dragun, Duska Coates, Patrick T |
| description | Atypical non HLA antibodies are increasingly recognised as causes of immunological injury in allotransplantation. In this report we describe a non HLA sensitized male renal allograft recipient who developed acute vascular rejection on a “for cause” biopsy (Banff v2, g2, ptc 3) at day 4 post first renal allograft in the presence of elevated angiotensin II type 1 receptor antibodies (AT1R‐Ab level 14.1). The acute rejection was treated with pulse corticosteroid therapy, anti‐thymocyte globulin (ATG × 6), plasma exchange (1.5 plasma volume replacement x6) and oral candesartan. Serum creatinine improved and follow up biopsy confirmed resolution of rejection following treatment. AT1R‐Ab should be considered when rejection is diagnosed in the absence of HLA antibodies. |
| doi_str_mv | 10.1111/nep.12421 |
| format | Article |
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In this report we describe a non HLA sensitized male renal allograft recipient who developed acute vascular rejection on a “for cause” biopsy (Banff v2, g2, ptc 3) at day 4 post first renal allograft in the presence of elevated angiotensin II type 1 receptor antibodies (AT1R‐Ab level 14.1). The acute rejection was treated with pulse corticosteroid therapy, anti‐thymocyte globulin (ATG × 6), plasma exchange (1.5 plasma volume replacement x6) and oral candesartan. Serum creatinine improved and follow up biopsy confirmed resolution of rejection following treatment. AT1R‐Ab should be considered when rejection is diagnosed in the absence of HLA antibodies.</description><identifier>ISSN: 1320-5358</identifier><identifier>EISSN: 1440-1797</identifier><identifier>DOI: 10.1111/nep.12421</identifier><identifier>PMID: 25807851</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject><![CDATA[Acute Disease ; Administration, Oral ; Adrenal Cortex Hormones - administration & dosage ; Adult ; Allografts ; Angiotensin II Type 1 Receptor Blockers - administration & dosage ; Antilymphocyte Serum - administration & dosage ; atypical antibody ; Autoantibodies - blood ; Benzimidazoles - administration & dosage ; Biopsy ; Graft Rejection - diagnosis ; Graft Rejection - immunology ; Graft Rejection - therapy ; Humans ; Immunosuppressive Agents - administration & dosage ; Kidney Transplantation - adverse effects ; Male ; non HLA antibodies ; Plasma Exchange ; Pulse Therapy, Drug ; Receptor, Angiotensin, Type 1 - drug effects ; Receptor, Angiotensin, Type 1 - immunology ; rejection ; Severity of Illness Index ; Tetrazoles - administration & dosage ; Time Factors ; Treatment Outcome ; Up-Regulation ; vascular]]></subject><ispartof>Nephrology (Carlton, Vic.), 2015-03, Vol.20 (S1), p.10-12</ispartof><rights>2015 Asian Pacific Society of Nephrology</rights><rights>2015 Asian Pacific Society of Nephrology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3981-35a2a75037c2e06f17551e3f5a1c8fe43e880fe71619f24e9b7040307a3b8a443</citedby><cites>FETCH-LOGICAL-c3981-35a2a75037c2e06f17551e3f5a1c8fe43e880fe71619f24e9b7040307a3b8a443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fnep.12421$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fnep.12421$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25807851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jobert, Anjelo</creatorcontrib><creatorcontrib>Rao, Nitesh</creatorcontrib><creatorcontrib>Deayton, Sue</creatorcontrib><creatorcontrib>Bennett, Greg D</creatorcontrib><creatorcontrib>Brealey, John</creatorcontrib><creatorcontrib>Nolan, James</creatorcontrib><creatorcontrib>Carroll, Robert P</creatorcontrib><creatorcontrib>Dragun, Duska</creatorcontrib><creatorcontrib>Coates, Patrick T</creatorcontrib><title>Angiotensin II type 1 receptor antibody precipitating acute vascular rejection in kidney transplantation</title><title>Nephrology (Carlton, Vic.)</title><addtitle>Nephrology</addtitle><description>Atypical non HLA antibodies are increasingly recognised as causes of immunological injury in allotransplantation. In this report we describe a non HLA sensitized male renal allograft recipient who developed acute vascular rejection on a “for cause” biopsy (Banff v2, g2, ptc 3) at day 4 post first renal allograft in the presence of elevated angiotensin II type 1 receptor antibodies (AT1R‐Ab level 14.1). The acute rejection was treated with pulse corticosteroid therapy, anti‐thymocyte globulin (ATG × 6), plasma exchange (1.5 plasma volume replacement x6) and oral candesartan. Serum creatinine improved and follow up biopsy confirmed resolution of rejection following treatment. AT1R‐Ab should be considered when rejection is diagnosed in the absence of HLA antibodies.</description><subject>Acute Disease</subject><subject>Administration, Oral</subject><subject>Adrenal Cortex Hormones - administration & dosage</subject><subject>Adult</subject><subject>Allografts</subject><subject>Angiotensin II Type 1 Receptor Blockers - administration & dosage</subject><subject>Antilymphocyte Serum - administration & dosage</subject><subject>atypical antibody</subject><subject>Autoantibodies - blood</subject><subject>Benzimidazoles - administration & dosage</subject><subject>Biopsy</subject><subject>Graft Rejection - diagnosis</subject><subject>Graft Rejection - immunology</subject><subject>Graft Rejection - therapy</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>non HLA antibodies</subject><subject>Plasma Exchange</subject><subject>Pulse Therapy, Drug</subject><subject>Receptor, Angiotensin, Type 1 - drug effects</subject><subject>Receptor, Angiotensin, Type 1 - immunology</subject><subject>rejection</subject><subject>Severity of Illness Index</subject><subject>Tetrazoles - administration & dosage</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Up-Regulation</subject><subject>vascular</subject><issn>1320-5358</issn><issn>1440-1797</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFO3DAQhi0EAko58AKVj3AIeGI7To4IwXbRFjjQ9mh5vRNqyDrBdtrm7Wu6wA1fxpr55tPoJ-QI2Cnkd-ZxOIVSlLBF9kEIVoBq1Hb-85IVkst6j3yK8ZExUGUFu2SvlDVTtYR98uvcP7g-oY_O0_mcpmlACjSgxSH1gRqf3LJfTXTILTe4ZJLzD9TYMSH9baIdOxMy_og2ud7TbHlyK48TTcH4OHRZYF4mn8lOa7qIh6_1gHy_ury_-Fosbmfzi_NFYXlTQ8GlKY2SjCtbIqtaUFIC8lYasHWLgmNdsxYVVNC0pcBmqZhgnCnDl7URgh-Q4413CP3ziDHptYsWu3wI9mPUUFWKC8WAZfRkg9rQxxiw1UNwaxMmDUy_BKtzsPp_sJn98qodl2tcvZNvSWbgbAP8cR1OH5v0zeXdm7LYbLiY8O_7hglPOp-opP55M9PXi2Y2-3F9p7_xf5PgkgI</recordid><startdate>201503</startdate><enddate>201503</enddate><creator>Jobert, Anjelo</creator><creator>Rao, Nitesh</creator><creator>Deayton, Sue</creator><creator>Bennett, Greg D</creator><creator>Brealey, John</creator><creator>Nolan, James</creator><creator>Carroll, Robert P</creator><creator>Dragun, Duska</creator><creator>Coates, Patrick T</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201503</creationdate><title>Angiotensin II type 1 receptor antibody precipitating acute vascular rejection in kidney transplantation</title><author>Jobert, Anjelo ; 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In this report we describe a non HLA sensitized male renal allograft recipient who developed acute vascular rejection on a “for cause” biopsy (Banff v2, g2, ptc 3) at day 4 post first renal allograft in the presence of elevated angiotensin II type 1 receptor antibodies (AT1R‐Ab level 14.1). The acute rejection was treated with pulse corticosteroid therapy, anti‐thymocyte globulin (ATG × 6), plasma exchange (1.5 plasma volume replacement x6) and oral candesartan. Serum creatinine improved and follow up biopsy confirmed resolution of rejection following treatment. AT1R‐Ab should be considered when rejection is diagnosed in the absence of HLA antibodies.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>25807851</pmid><doi>10.1111/nep.12421</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Administration, Oral Adrenal Cortex Hormones - administration & dosage Adult Allografts Angiotensin II Type 1 Receptor Blockers - administration & dosage Antilymphocyte Serum - administration & dosage atypical antibody Autoantibodies - blood Benzimidazoles - administration & dosage Biopsy Graft Rejection - diagnosis Graft Rejection - immunology Graft Rejection - therapy Humans Immunosuppressive Agents - administration & dosage Kidney Transplantation - adverse effects Male non HLA antibodies Plasma Exchange Pulse Therapy, Drug Receptor, Angiotensin, Type 1 - drug effects Receptor, Angiotensin, Type 1 - immunology rejection Severity of Illness Index Tetrazoles - administration & dosage Time Factors Treatment Outcome Up-Regulation vascular |
| title | Angiotensin II type 1 receptor antibody precipitating acute vascular rejection in kidney transplantation |
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