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NDT Plus Advance Access published online on November 5, 2009
NDT Plus, doi:10.1093/ndtplus/sfp157
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© The Author 2009. Published by Oxford University Press [on behalf of ERA-EDTA]. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Severe hypogammaglobulinaemia and opportunistic infections after rituximab therapy in a renal transplant recipient

Arzu Kahveci, Ebru Asicioglu, Elif Ari, Hakki Arikan, Serhan Tuglular and Cetin Ozener

Division of Nephrology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey

Correspondence: Arzu Kahveci; E-mail: drarzukahveci{at}yahoo.com


  Abstract

Infectious complications are the leading causes of morbidity and mortality among renal transplant recipients. Hypogammaglobulinaemia may develop as a result of immunosuppressive therapy and is associated with an increased risk of opportunistic infections particularly in the 6-month post-transplant period. Rituximab, which is used for antibody-mediated rejection (AMR), may also contribute to the development of hypogammaglobulinaemia via B-cell depletion. Intravenous immunoglobulin replacement may be beneficial in this setting. With the following case report, we aim to increase the awareness of opportunistic infections and severe hypogammaglobulinaemia in renal transplant recipients treated with rituximab for acute AMR.

Key Words: hypogammaglobulinaemia • infection • renal transplantation • rituximab

Received for publication April 15, 2009. Accepted for publication October 5, 2009.


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