Buradasınız

Remisyonda Hodgkin Lenfoma ve Behçet Hastalığı Olan bir Hastada Başarılı Böbrek Nakli

Successful Renal Transplantation in a Patient with Behcet Disease and Hodgkin Lymphoma in Remission

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2011.1002.14
Abstract (2. Language): 
Behcet’s disease (BD) is an inflammatory multisystemic disease characterized by perivascular inflammation and generally presents with recurrent oral and genital ulcers and uveitis. It is known that BD may also involve the kidneys. Amyloidosis, glomerulonephritis (crescentic, proliferative), IgA nephropathy, interstitial nephritis are commonly described renal lesions which may lead to end-stage renal disease (ESRD) in BD. Immunosuppressive therapies used for the treatment of BD may cause malignant diseases (lymphoma, skin and solid organ malignancies, etc). The risk with azathioprin is especially high after 10 years of treatment. Cyclosporine, another immunosuppressive agent frequently used for treatment of BD, also has tumorigenic potential and is associated with renal toxicity and renal failure. Renal transplantation may be performed in patients with malignancies after a 2-5 year complete remission period, although it may differ according to the type of tumor. We report a case of end-stage renal disease and Hodgkin’s lymphoma occurring after treatment with immunosuppressive medicine for BD. The patient was successfully treated with renal transplantation.
Abstract (Original Language): 
Behçet hastalığı (BH), tekrarlayan oral ve genital ülserler, üveit ve perivasküler inflamasyonla karakterize enflamatuvar bir çok sistemi tutan bir hastalıktır. Amiloidozis, glomerülonefritler (kresentik, proliferatif), IgA nefropatisi ve interstisyel nefrit BH’da görülen böbrek tutulum şekilleri olup son dönem böbrek yetmezliğine neden olabilmektedirler. BH tedavisinde kullanılan immünosupresifler malign hastalıklara (lenfoma, deri ve solid organ tümörleri gibi) sebep olabilirler. Azatioprin 10 yıldan fazla kullanıldığında bu risk belirgin olarak artmaktadır. BH’nda yaygın olarak kullanılan siklosporin ise tümör gelişimini kolaylaştırıcı etken olmakla birlikte nefrotoksisite ve böbrek yetmezliği yapma riski de bulunmaktadır. Tümörün tipine göre değişmekle birlikte malignitesi olan hastalara 2-5 yıllık tam düzelme sürecinden sonra böbrek nakli yapılabilir. Çalışmamızda, Behçet Hastalığı tanısıyla immünosüpresif tedavi almış, sonrasında Hodgkin Lenfoma ve son dönem böbrek yetmezliği gelişmiş hastaya yapılan başarılı bir böbrek nakli olgusu sunulmuştur.
195-199

REFERENCES

References: 

1. Toprak O, Ersoy R, Uzum A, Memis A, Cirit M, Akpolat T: An
unusual vascular involvement in a patient with Behcet’s disease:
Renal artery stenosis. Am J Med Sci 2007; 334(5): 396-398
2. Akpolat T, Dilek M, Aksu K, Keser G, Toprak O, Cirit M, Oğuz Y,
Taşkapan H, Adibelli Z, Akar H, Tokgöz B, Arici M, Celiker H, Diri
B, Akpolat I: Renal Behçet’s disease: An update. Semin Arthritis
Rheum 2008; 38(3): 241-248
3. Altiparmak MR, Tanverdi M, Pamuk ON, Tunç R, Hamuryudan V:
Glomerulonephritis in Behçet’s disease: Report of seven cases and
review of the literature. Clin Rheumatol 2002; 21(1): 14-18
4. Kim SD, Kim SH, Kim HR, Yoon CH, Lee SH, Park SH, Kim HY:
Rapidly-progressive glomerulonephritis in a patient with Behcet’s
disease: Successful treatment with intravenous cyclophosphamide.
Rheumatol Int 2005; 25: 540-542
5. Fernandes PF, Júnior GB, Barros FA, Sousa DC, Franco LM,
Patrocínio RM: Behcet’s disease and IgA nephropathy: Report
of this association in a patient from Brazil and literature review.
Invest Clin 2006; 47(4): 405-411
6. Altay M, Duranay M, Koçsar Y, Kaya R, Ecemis Z.A: Ig A
nefropatisi ile birlikte seyreden Behçet hastalıği. Turk Neph Dial
Transpl 2006; 15: 60
7. Ozkurt H, Oztora F, Tunc S, Basak M: Pseudoaneurysm of the
renal interlobar artery in Behçet’s disease. Acta Radiol 2006; 47(9):
1000-1002
8. Bobadilla NA, Gamba G: New insights into the pathophysiology of
cyclosporine nephrotoxicity: A role of aldosterone. Am J Physiol
Renal Physiol 2007; 293: 2-9
9. Hortelano S, Castilla M, Torres AM, Tejedor A, Bosca L:
Potentiation by nitric oxide of cyclosporin A and FK506-induced
apoptosis in renal proximal tubule cells. J Am Soc Nephrol 2000;
11 : 2315-2323
10. Morozumi K, Takeda A, Uchida K, Mihatsch MJ: Cyclosporine
nephrotoxicity: How does it affect renal allograft function and
transplant morphology? Transpl Proc 2004; 36 : 251-256
11. Roos-van Groningen MC, Scholten EM, Lelieveld PM, Rowshani
AT, Baelde HJ, Bajema IM, Florquin S, Bemelman FJ, de Heer
E, de Fijter JW, Bruijn JA, Eikmans M: Molecular comparison of
calcineurin inhibitor-induced fibrogenic responses in protocol renal
transplant biopsies. J Am Soc Nephrol 2006; 17: 881-888
12. Feldman G, Kiely B, Martin N, Ryan G, McMorrow T, Ryan MP:
Role for TGF-beta in cyclosporine-induced modulation of renal
epithelial barrier function. J Am Soc Nephrol 2007; 18: 1662-1671
13. Hertig A, Verine J, Mougenot B, Jouanneau C, Ouali N, Sebe P,
Glotz D, Ancel PY, Rondeau E, Xu-Dubois YC: Risk factors for
early epithelial to mesenchymal transition in renal grafts. Am J
Transplant 2006; 6: 2937-2946
14. Hertig A, Anglicheau D, Verine J, Pallet N, Touzot M, Ancel PY,
Mesnard L, Brousse N, Baugey E, Glotz D, Legendre C, Rondeau
E, Xu-Dubois YC: Early epithelial phenotypic changes predict graft
fibrosis. J Am Soc Nephrol 2008; 19: 1584-1591
15. Hazzan M, Hertig A, Buob D, Noel C, Copin MC, Rondeau E,
Xu-Dubois YC: Cyclosporin induces epithelial to mesenchymal
transition in renal grafts. Am J Transplant 2008; 8: 214-215
16. Wong G, Chapman JR: Cancers after renal transplantation.
Transplant Rev (Orlando) 2008; 22(2): 141-149
17. Kapoor A: Malinnancy in kidney transplant recipients. Drugs 2008;
68: 11-19
18. Harzallah K, Abderrahim E, Chareffedine K, Yeich S, Belhadj R,
Skhiri H, Younsi F, Abdallah TB, Abdelletif A, Hachicha J, Hmida
J, El May M, Khedr A, Manaa J: Cancers after renal transplantation:
Multicenter experience. Saudi J Kidney Dis Transpl 2008; 19(5):
825-830
19. Doutrelepont JM, De Pauw L, Gruber SA, Dunn DL, Qunibi
W, Kinnaert P, Vereerstraeten P, Penn I, Abramowicz D: Renal
transplatation exposes patients with previous Kaposi’s sarcoma to
a high risk of recurrence. Transplantation 1996; 62: 463-466
20. Chiang YJ, Wang HH, Liu KL, Chu SH, Lee WC: Hepatocellular
carcinoma following renal transplantation: Experience in northern
Taiwan. Transplant Proc 2008; 40(7): 2397-2399
21. Caillard S, Agodoa LY, Bohen EM, Abbott KC: Myeloma, Hodgkin
disease and lymphoid leukemia after renal transplantation:
Characteristics, risk factors and prognosis. Transplantation 2006;
81(6): 888-895
22. Kleinclauss F, Gigante M, Neuzillet Y, Mouzin M, Terrier N,
Salomon L, Iborra F, Petit J, Cormier L, Lechevallier E: Renal
Transplantation Committee of the French Urological Association
(AFU). Prostate cancer in renal transplant recipients. Nephrol Dial
Transplant 2008; 23(7): 2374-2380
23. Apaydın S, Erek E, Ülkü U, Hamuryudan V, Yazıcı H, Sarıyar M: A
successful renal transplantation in Behçet’s syndrome. Ann Rheum
Dis 1999; 58: 719

Thank you for copying data from http://www.arastirmax.com