Nephrology - Kidney Transplant Unit, Rouen University Hospital, 76031 Rouen, France.
Immunotherapy. 2018 Jul;10(9):737-742. doi: 10.2217/imt-2017-0135.
Antithymocyte globulin is the most widely used lymphocyte-depleting treatment in kidney transplantation. In spite of the frequency of side effects, including anemia and thrombocytopenia, their pathophysiological mechanisms are not clearly established. Here, we report the case of a 21-year-old patient who had a first kidney transplantation and received induction immunosuppressive therapy by thymoglobulin. Immediately after kidney transplantation, he developed a severe hemolytic anemia and thrombocytopenia with a subsequent perirenal hematoma, which lead to a second surgical procedure and a transfer to the intensive care unit. Our patients' anemia and thrombocytopenia had heteroimmune characteristics, and thymoglobulin therapy was suspected to be the cause, via an interaction with a common Fc-receptor epitope in the different cell lines.
抗胸腺细胞球蛋白是肾移植中最广泛应用的淋巴细胞耗竭治疗药物。尽管其副作用包括贫血和血小板减少症等较为常见，但这些副作用的病理生理机制尚不清楚。在这里，我们报告了一例 21 岁患者的病例，该患者首次接受肾移植，并接受了胸腺球蛋白诱导的免疫抑制治疗。在肾移植后，他立即出现严重的溶血性贫血和血小板减少症，随后出现肾周血肿，导致进行了第二次手术，并转入重症监护病房。我们的患者的贫血和血小板减少症具有异免疫特征，并且怀疑是由于胸腺球蛋白治疗与不同细胞系中的共同 Fc 受体表位相互作用所致。
