کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8827217 | 1610664 | 2018 | 4 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Management of Juvenile Idiopathic Arthritis in ABO-incompatible Kidney Transplantation: A Case Report
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موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
عمل جراحی
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چکیده انگلیسی
Biologic agents are a beneficial therapy for juvenile idiopathic arthritis (JIA). However, there is a lack of evidence with regard to management of these agents for JIA patients who undergo kidney transplantation (KTx). A 36-year-old woman with JIA who was treated with tocilizumab targeting interleukin-6 (IL-6) receptor underwent ABO-incompatible kidney transplantation (ABOi KTx). To prevent over-immunosuppression, tocilizumab was discontinued before ABOi KTx. Rituximab, tacrolimus, mycophenolate mofetil, everolimus, and methylprednisolone were used for immunosuppression. Clinical remission of joint pain was maintained for over 3 years despite complete discontinuation of tocilizumab. Both serum IL-6 and soluble IL-6 receptor levels were markedly decreased, suggesting that multitargeted immunosuppression for ABOi KTx induced long-term clinical remission of JIA through inhibition of the IL-6 pathway. However, levels of C-reactive protein (CRP) and matrix metalloproteinase-3 (MMP-3) gradually increased thereafter and abatacept was initiated to prevent joint deterioration. These levels decreased without any adverse events. The patient's renal graft function was well maintained.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Transplantation Proceedings - Volume 50, Issue 3, April 2018, Pages 869-872
Journal: Transplantation Proceedings - Volume 50, Issue 3, April 2018, Pages 869-872
نویسندگان
S. Ishikawa, M. Tasaki, T. Kuroda, D. Kobayashi, K. Saito, Y. Nakagawa, M. Ikeda, K. Takahashi, Y. Tomita,