Pneumocystis jirovecii pneumonia after rituximab therapy for antibody-mediated rejection in a renal transplant recipient

Transpl Infect Dis. 2009 Apr;11(2):167-70. doi: 10.1111/j.1399-3062.2008.00345.x. Epub 2008 Sep 18.

Abstract

We report the case of a 54-year-old woman who underwent living-related renal transplantation for end-stage renal disease from IgA nephropathy. She was subsequently diagnosed with antibody-mediated rejection (AMR) and received rituximab, a potent B-cell suppressive agent. After therapy with rituximab, she developed Pneumocystis jirovecii pneumonia (PJP) requiring hospitalization. We discuss the increasing literature for the use of rituximab for AMR and the need for PJP prophylaxis in this setting.

Publication types

  • Case Reports

MeSH terms

  • Anti-Infective Agents / therapeutic use
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Murine-Derived
  • Atovaquone / therapeutic use
  • Female
  • Graft Rejection / prevention & control
  • Humans
  • Immunologic Factors / adverse effects*
  • Immunologic Factors / therapeutic use
  • Injections, Intravenous
  • Kidney Transplantation / adverse effects*
  • Middle Aged
  • Pneumocystis carinii*
  • Pneumonia, Pneumocystis / diagnostic imaging
  • Pneumonia, Pneumocystis / etiology*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / microbiology*
  • Radiography
  • Rituximab
  • Tomography Scanners, X-Ray Computed
  • Treatment Outcome
  • Trimethoprim / therapeutic use

Substances

  • Anti-Infective Agents
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Immunologic Factors
  • Rituximab
  • Trimethoprim
  • Atovaquone