Vargas Federico, Gedalia Abraham, Craver Randall D, Matti Vehaskari V
Departments of Pediatrics and Pathology, Children's Hospital and Louisiana Health Sciences Center, New Orleans, LA 70118,USA.
Pediatr Transplant. 2010 Aug;14(5):e54-7. doi: 10.1111/j.1399-3046.2009.01173.x. Epub 2009 Mar 28.
Sarcoidosis is a multisystemic disease of unknown etiology. Minor renal involvement is not rare but kidney failure is uncommon and only rare cases of recurrent disease in a kidney transplant have been published. We report a patient who at age 10 yr developed ESRD secondary to renal sarcoidosis with GIN. Her disease subsequently recurred in the transplanted kidney despite standard immunosuppression with prednisone, tacrolimus, and mycophenolate mofetil. The recurrent disease appeared to respond to increased immunosuppression, which included infliximab. However, the patient died of disseminated histoplasmosis three yr post-transplant.
结节病是一种病因不明的多系统疾病。肾脏轻度受累并不罕见,但肾衰竭并不常见,仅有罕见的肾移植复发病例被报道。我们报告一名10岁的患者,因肾结节病合并肾小球间质性肾炎导致终末期肾病。尽管使用泼尼松、他克莫司和霉酚酸酯进行标准免疫抑制治疗,其疾病仍在移植肾中复发。复发病例似乎对增加免疫抑制治疗有反应,包括英夫利昔单抗。然而,该患者在移植后三年死于播散性组织胞浆菌病。