PMID- 17326779
OWN - NLM
STAT- MEDLINE
DCOM- 20070427
LR  - 20151119
IS  - 0934-0874 (Print)
IS  - 0934-0874 (Linking)
VI  - 20
IP  - 4
DP  - 2007 Apr
TI  - Recurrence of light chain deposit disease after renal allograft transplantation: 
      potential role of rituximab?
PG  - 381-5
AB  - Light chain deposit disease (LCDD) is a monoclonal plasma cell disorder 
      characterized by tissue deposition of nonamyloid immunoglobulin light chains, 
      predominantly kappa chains, causing renal insufficiency. LCDD reoccurs almost 
      invariably after renal grafting, leading to early graft loss, usually within a 
      time span of months to years. We describe a female patient with LCDD who lost her 
      first living donor graft after 1 year due to extensive recurrence of kappa chain 
      deposition. Rituximab was administered on the seventh day after her second 
      transplantation with a graft from a deceased donor, in order to prevent early 
      recurrence of LCDD. The 2-year protocol biopsy - similarly to the completely 
      normal 1-year protocol biopsy - revealed persistent absence of light chain 
      deposition on light microscopy but immunohistochemical staining and electron 
      microscopy showed very mild recurrence of light chain deposits. A second 4-week 
      course of rituximab was repeated because of these electron microscopic findings. 
      Subsequently, free kappa light chain concentration decreased from 693 to 74 mg/l 
      and remained low 4 months after completion of therapy. Rituximab could be 
      considered for delaying early LCDD recurrence in patients in whom treatment of 
      the underlying bone marrow disorder failed or is contraindicated, but maintenance 
      therapy is apparently necessary to consolidate this response.
FAU - Kuypers, Dirk R J
AU  - Kuypers DR
AD  - Department of Nephrology and Renal Transplantation, University Hospitals Leuven, 
      Leuven, Belgium. dirk.kuypers@uz.kuleuven.ac.be
FAU - Lerut, Evelyne
AU  - Lerut E
FAU - Claes, Kathleen
AU  - Claes K
FAU - Evenepoel, Pieter
AU  - Evenepoel P
FAU - Vanrenterghem, Yves
AU  - Vanrenterghem Y
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 0 (Immunoglobulin Light Chains)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Murine-Derived
MH  - Female
MH  - Humans
MH  - *Immunoglobulin Light Chains/analysis
MH  - Kidney Transplantation/*adverse effects
MH  - Middle Aged
MH  - Paraproteinemias/*drug therapy/*pathology
MH  - Rituximab
MH  - *Secondary Prevention
EDAT- 2007/03/01 09:00
MHDA- 2007/04/28 09:00
CRDT- 2007/03/01 09:00
PHST- 2007/03/01 09:00 [pubmed]
PHST- 2007/04/28 09:00 [medline]
PHST- 2007/03/01 09:00 [entrez]
AID - TRI437 [pii]
AID - 10.1111/j.1432-2277.2006.00437.x [doi]
PST - ppublish
SO  - Transpl Int. 2007 Apr;20(4):381-5. doi: 10.1111/j.1432-2277.2006.00437.x.