{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:16:33Z","timestamp":1765368993486},"reference-count":16,"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>A kidney transplant case with de novo donor\u2010specific antibody showed monoclonal plasma cell infiltration into the graft with <jats:styled-content style=\"fixed-case\">ABO<\/jats:styled-content> incompatibility. Three years after transplantation, the patient's graft function suddenly deteriorated. Interstitial edema and the predominant infiltration of inflammatory plasma cells with kappa chain monoclonality were observed in biopsy specimens. The in situ hybridization of <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>pstein\u2013<jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>arr virus was negative and post\u2010transplant lymphoproliferative disorder was not evident from radiological examinations. On laboratory examination, the patient had de novo donor\u2010specific antibody for <jats:styled-content style=\"fixed-case\">HLA\u2010DQ<\/jats:styled-content>. We suspected plasma cell\u2010rich acute rejection for which methylprednisolone pulse therapy, plasma exchange, rituximab, and 15\u2010deoxyspergualin were given. In the ensuing biopsy, the degree of plasma cell infiltration was similar to the first biopsy; however, kappa chain monoclonality relatively weakened. Owing to resistance to these treatments, intravenous immunoglobulin (<jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content>) (0.5\u2009g\/kg\/day) was added. The serum creatinine level gradually declined to 3.1\u2009mg\/dL; however, it increased up to 3.6\u2009mg\/dL again. In the final biopsy, the infiltrated plasma cells disappeared but severe interstitial fibrosis developed. This case showed difficulty in the diagnosis and treatment of plasma cell\u2010rich acute rejection. A detailed consideration of this case may be helpful in understanding the clinical features and pathogenesis of this condition.<\/jats:p>","DOI":"10.1111\/nep.12471","type":"journal-article","created":{"date-parts":[[2015,6,2]],"date-time":"2015-06-02T23:42:53Z","timestamp":1433288573000},"page":"66-69","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A suspected case of plasma cell\u2010rich acute renal transplant rejection associated with de novo donor\u2010specific antibody"],"prefix":"10.1111","volume":"20","author":[{"given":"Mikiko","family":"Yoshikawa","sequence":"first","affiliation":[{"name":"Division of Nephrology Kidney Center Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Division of Nephrology Kidney Center Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Ishimura","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery Related Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeo","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masato","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery Related Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Nishi","sequence":"additional","affiliation":[{"name":"Division of Nephrology Kidney Center Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,2]]},"reference":[{"issue":"1","key":"e_1_2_5_2_1","first-page":"897","article-title":"Acute interstitial nephritis of plasma cells: A new cause for renal allograft loss","volume":"25","author":"David\u2010Neto E","year":"1993","journal-title":"Transplant. 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