Preserved endocrine function in a pancreas transplant recipient with pancreatic panniculitis and antibody-mediated rejection.

Abstract

Pancreas transplantation is an effective treatment option for patients with complicated diabetes mellitus. Pancreas allograft recipients are followed with laboratory markers such as serum amylase, lipase and glucose levels. Hyperglycemia may indicate severe acute rejection and has recently been associated with antibody-mediated (humoral) rejection. In this report, we describe a unique case of a pancreas-after-kidney (PAK) transplant recipient with the rare presentation of pancreatic panniculitis, biopsy-proven severe acute cellular and antibody-mediated pancreas allograft rejection and surprisingly well-preserved endocrine function despite treatment with high dose steroids. We discuss the clinicopathologic features of antibody-mediated pancreas rejection, including the importance of correlating pancreas allograft biopsy, C4d staining and donor specific antibodies, to diagnose antibody-mediated rejection and initiate the correct treatment.

• Authors: M Prikis, D Norman, S Rayhill, A Olyaei, M Troxell, A Mittalhenkle
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 10 Issue 12 Pg. 2717-22 (Dec 2010) ISSN: 1600-6143 [Electronic] United States
• PMID: 21114649 (Publication Type: Case Reports, Journal Article)
• Copyright: ©2010 The Authors Journal compilation©2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

Chemical References

• Immunoglobulins, Intravenous
• Ganciclovir

Topics

• Adult
• Cytomegalovirus Infections (drug therapy)
• Diabetic Nephropathies (surgery)
• Female
• Ganciclovir (therapeutic use)
• Graft Rejection (drug therapy, immunology)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Kidney (physiology)
• Kidney Transplantation (immunology)
• Pancreas Transplantation (adverse effects)
• Pancreatic Diseases (etiology)
• Panniculitis (etiology)
• Plasmapheresis