{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:15:41Z","timestamp":1765368941212},"reference-count":10,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2014,5,20]],"date-time":"2014-05-20T00:00:00Z","timestamp":1400544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report a case of plasma cell\u2010rich rejection accompanied by acute antibody\u2010mediated rejection in a patient with <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content>\u2010incompatible kidney transplantation. A 33\u2010year\u2010old man was admitted for an episode biopsy; he had a serum creatinine (<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>r) level of 5.7\u2009mg\/dL 1 year following primary kidney transplantation. Histological features included two distinct entities: (1) a focal, aggressive tubulointerstitial inflammatory cell (predominantly plasma cells) infiltration with moderate tubulitis; and (2) inflammatory cell infiltration (including neutrophils) in peritubular capillaries. Substantial laboratory examination showed that the patient had donor\u2010specific antibodies for <jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content>4 and <jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content>6. Considering both the histological and laboratory findings, we diagnosed him with plasma cell\u2010rich rejection accompanied by acute antibody\u2010mediated rejection. We started 3 days of consecutive steroid pulse therapy three times every 2 weeks for the former and plasma exchange with intravenous immunoglobulin (<jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content>) for the latter histological feature. One month after treatment, a second allograft biopsy showed excellent responses to treatment for plasma cell\u2010rich rejection, but moderate, acute antibody\u2010mediated rejection remained. Therefore, we added plasma exchange with <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content> again. After treatment, allograft function was stable, with an <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>r level of 2.8\u2009mg\/dL. This case report demonstrates the difficulty of the diagnosis of, and treatment for, plasma cell\u2010rich rejection accompanied by acute antibody\u2010mediated rejection in a patient with <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content>\u2010incompatible kidney transplantation. We also include a review of the related literature.<\/jats:p>","DOI":"10.1111\/nep.12245","type":"journal-article","created":{"date-parts":[[2014,5,20]],"date-time":"2014-05-20T07:26:00Z","timestamp":1400570760000},"page":"31-34","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Plasma cell\u2010rich rejection accompanied by acute antibody\u2010mediated rejection in a patient with <scp>ABO<\/scp>\u2010incompatible kidney transplantation"],"prefix":"10.1111","volume":"19","author":[{"given":"Maiko","family":"Furuya","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akimitsu","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyuki","family":"Nakada","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Sugano","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yudo","family":"Tanno","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Ohkido","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuo","family":"Tsuboi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyasu","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Atsugi City Hospital  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keitaro","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Yokoo","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Internal Medicine The Jikei University School of Medicine  Tokyo 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