{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T22:28:09Z","timestamp":1695680889967},"reference-count":12,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2015,6,2]],"date-time":"2015-06-02T00:00:00Z","timestamp":1433203200000},"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":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We herein report a refractory case of subclinical antibody\u2010mediated rejection (<jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content>) due to anti\u2010<jats:styled-content style=\"fixed-case\">HLA\u2010DQ<\/jats:styled-content> antibody in a kidney transplant patient. A 45\u2010year\u2010old man was admitted for a protocol 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 1.8\u2009mg\/dL 3 years following primary kidney transplantation. Histological examination revealed moderate to severe inflammatory cell infiltration in the peritubular capillaries. Thorough laboratory examination showed that the patient had donor\u2010specific antibodies (<jats:styled-content style=\"fixed-case\">DSAbs<\/jats:styled-content>) to <jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content>9 and <jats:styled-content style=\"fixed-case\">DQ9<\/jats:styled-content>. Considering both the histological and laboratory findings, we diagnosed acute antibody\u2010mediated rejection. The patient underwent 3 days of consecutive steroid pulse therapy, intravenous immunoglobulin (<jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content>), and plasma exchange. We also administered rituximab (200\u2009mg\/body). Six months after the treatment, a second allograft biopsy revealed the progression of interstitial fibrosis and tubular atrophy and persistence of mild peritubular capillaritis. Further analysis showed that the anti\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content>9 antibodies had disappeared, but that the mean fluorescence intensity value of the anti\u2010<jats:styled-content style=\"fixed-case\">DQ9<\/jats:styled-content> antibodies had increased. Therefore, we repeated the plasma exchange and <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content>. Allograft function was stable throughout the course of treatment, and the <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>r level remained at 1.8\u2009mg\/dL. This case report demonstrates the difficulty of treating <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> due to the presence of anti\u2010<jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> DSAbs and the necessity for subsequent therapies in refractory cases.<\/jats:p>","DOI":"10.1111\/nep.12453","type":"journal-article","created":{"date-parts":[[2015,6,2]],"date-time":"2015-06-02T23:42:53Z","timestamp":1433288573000},"page":"81-85","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A refractory case of subclinical antibody\u2010mediated rejection due to anti\u2010<scp>HLA\u2010DQ<\/scp> antibody in a kidney transplant patient"],"prefix":"10.1111","volume":"20","author":[{"given":"Toshinari","family":"Fujimoto","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":"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":"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":"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":"Hiroki","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Urology The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Miki","sequence":"additional","affiliation":[{"name":"Department of Urology 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":"Takashi","family":"Yokoo","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"}]}],"member":"311","published-online":{"date-parts":[[2015,6,2]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3182543950"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.190"},{"key":"e_1_2_4_4_1","article-title":"Differential Modulation of Donor\u2010Specific Antibodies After B\u2010Cell Depleting Therapies to Cure Chronic Antibody Mediated Rejection","author":"Touzot M","year":"2014","journal-title":"Transplantation"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000191"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01644.x"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318222c9c6"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31825d1587"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr465"},{"key":"e_1_2_4_10_1","first-page":"323","article-title":"A summary of bortezomib use in transplantation across 29 centers","author":"Everly MJ","year":"2009","journal-title":"Clin. Trranspl."},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2011.502"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V9112129"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.01979.x"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnep.12453","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.12453","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T23:13:51Z","timestamp":1694474031000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.12453"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,2]]},"references-count":12,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1111\/nep.12453"],"URL":"https:\/\/doi.org\/10.1111\/nep.12453","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,2]]},"assertion":[{"value":"2015-03-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-06-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}