Abstract:
:A 4-year-old boy presented 14 months after liver and small bowel transplantation with fever, diarrhea, elevated liver enzymes, thrombocytopenia and autoantibodies. Total gammaglobulins level was normal but the level of plasma IgA1 was very high. The blood PCR for Epstein-Barr virus (EBV) was negative. The ileal biopsy disclosed a lymphoplasmacytic infiltration. The EBER probe was negative on the small bowel biopsies. The child was considered as suffering from a non-EBV-induced posttransplant lymphoproliferative disorder (PTLD). The high IgA level was presumed to be secreted by proliferating plasma cells in the transplanted bowel. Immunosuppression was reduced; but the efficacy was incomplete and an anti-CD20 antibody was added. There was complete resolution of symptoms and normalization of the IgA level. As IgA1 is mostly of intestinal origin, this unusual presentation of PTLD should lead to a high suspicion of a small bowel proliferating process.
journal_name
Pediatr Transplantjournal_title
Pediatric transplantationauthors
Robert CD,Lacaille F,Canioni D,Quartier-dit-Maire P,Talbotec C,Goulet Odoi
10.1111/j.1399-3046.2004.00174.xkeywords:
subject
Has Abstractpub_date
2004-06-01 00:00:00pages
305-7issue
3eissn
1397-3142issn
1399-3046pii
PTR174journal_volume
8pub_type
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pub_type: 杂志文章
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journal_title:Pediatric transplantation
pub_type: 杂志文章
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更新日期:2010-12-01 00:00:00
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journal_title:Pediatric transplantation
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journal_title:Pediatric transplantation
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更新日期:2006-08-01 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13231
更新日期:2018-06-03 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13773
更新日期:2020-09-01 00:00:00
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