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A case of early recurrent immunoglobulin A nephropathy and T-cell-mediated rejection in a transplant patient with Wiskott–Aldrich syndrome

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Abstract

Wiskott–Aldrich syndrome (WAS) is an X-chromosome recessive immunodeficiency disease characterized by the triad of thrombocytopenia, eczema, and susceptibility to infection owing to WAS protein gene abnormalities. Kidney transplantation is rarely offered to WAS patients with end-stage renal disease because of concerns that thrombocytopenia and immune disorders may affect the clinical outcome. Here, we report the case of a 20-year-old kidney transplant patient who developed end-stage renal disease owing to immunoglobulin (Ig)A nephropathy caused by WAS. Despite recurrent IgA nephropathy and T-cell-mediated rejection 7 months after transplantation, two rounds of steroid pulse therapy attenuated his renal function and urinary abnormality. His serum creatinine level was maintained at approximately 1.5 mg/dL 1 year after transplantation. No other WAS-related complications were observed throughout the clinical course. Although WAS can cause poor prognosis in kidney transplant patients, careful follow-up may allow kidney transplantation to be performed.

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Acknowledgements

The pathological findings of this case were diagnosed by Dr. Takashi Taguchi and Dr. Satoshi Hisano. Unfortunately, both have since passed away.

Funding

The authors received no specific funding for this study.

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Authors and Affiliations

  1. Department of Nephrology, National Hospital Organization Nagasaki Medical Center, Omura, Japan

    Kosei Yamaguchi

  2. Department of Nephrology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Kosei Yamaguchi, Mineaki Kitamura, Yuki Kawaguchi, Kanako Hayashi, Kumiko Muta, Masayuki Nakazawa & Tomoya Nishino

  3. Department of Urology, National Hospital Organization Nagasaki Medical Center, Omura, Japan

    Tsuyoshi Matsuda, Toru Onita & Masaharu Nishikido

  4. Department of Urology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan

    Tsuyoshi Matsuda & Hideki Sakai

  5. Department of Respiratory Medicine, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan

    Hiroshi Mukae

Authors
  1. Kosei Yamaguchi
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  2. Mineaki Kitamura
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  3. Yuki Kawaguchi
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  4. Kanako Hayashi
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  5. Kumiko Muta
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  6. Masayuki Nakazawa
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  7. Tsuyoshi Matsuda
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  8. Toru Onita
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  9. Masaharu Nishikido
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  10. Hideki Sakai
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  11. Hiroshi Mukae
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  12. Tomoya Nishino
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Corresponding author

Correspondence to Mineaki Kitamura.

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The authors declare no conflict of interest.

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The present report and all procedures described in it have been carried out in accordance with the 1964 Declaration of Helsinki and its later amendments.

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The patient provided a signed informed consent form for publication of the case report.

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Cite this article

Yamaguchi, K., Kitamura, M., Kawaguchi, Y. et al. A case of early recurrent immunoglobulin A nephropathy and T-cell-mediated rejection in a transplant patient with Wiskott–Aldrich syndrome. CEN Case Rep 11, 60–66 (2022). https://doi.org/10.1007/s13730-021-00631-9

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  • DOI: https://doi.org/10.1007/s13730-021-00631-9

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