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Nephrol Dial Transplant (2004) 19: 1918-1920
Nephrol Dial Transplant Vol. 19 No. 7 © ERA-EDTA 2004; all rights reserved

Case Report

Fulminant post-transplant lymphoproliferative disorder presenting with lactic acidosis and acute liver failure

Rashmi V. Mathur1, Goura Kudesia2, Kim Suvarna3 and William McKane1

1 Sheffield Kidney Institute, 2 Public Health Laboratory Service and 3 Department of Histopathology, Northern General Hospital, Sheffield, UK

Correspondence and offprint requests to: William McKane, Sheffield Kidney Institute, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. Email: william.mckane@sth.nhs.uk

Keywords: Epstein–Barr virus; immunosuppression; kidney transplantation; lymphoma; post-transplant malignancy

The first 150 words of the full text of this article appear below.



   Introduction
 
Post-transplant lymphoproliferative disorder (PTLD) is the most common non-cutaneous malignancy in solid organ transplant recipients and is associated with significant mortality. In renal transplant recipients the incidence has been estimated to be between 0.2 and 2.3% [1,2]. Most PTLD is driven by Epstein–Barr virus (EBV) infection. The risk of lymphoma in transplant recipients is up to 40 times that of the general population [1]. A spectrum of severity is seen and this reflects the degree of additional oncogene activation and the associated transition from a polyclonal to a monoclonal disease [3]. Extra-nodal disease is common and as a consequence the presentation is often subtle and the diagnosis delayed.

There are two principle risk factors for the development of PTLD: the intensity of immunosuppression and the EBV status of the donor and recipient. High dose immunosuppression with ciclosporin, tacrolimus, or anti-lymphocyte antibodies are . . . [Full Text of this Article]



   Case
 


   Discussion
 

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