{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:28:23Z","timestamp":1768523303486,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This case report highlights a successful steroid\u2010free, low\u2010dose immunosuppressive protocol for renal transplantation in a pediatric patient with Schimke immuno\u2010osseous dysplasia with excellent 7\u2010year patient and graft survival. Schimke immuno\u2010osseous dysplasia is a rare multisystem disorder involving the kidney. Renal transplantation is a therapeutic option, but posttransplant mortality is high due to severe infections and posttransplant lymphoproliferative disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 10\u2010year\u2010old girl diagnosed with Schimke immuno\u2010osseous dysplasia and end\u2010stage renal disease underwent an AB0\u2010compatible living\u2010related kidney transplantation, with no donor\u2010specific antibodies. Our standard immunosuppression protocol was modified due to the risk of infection. Basiliximab was used as induction therapy, and a reduced dose of mycophenolate mofetil and tacrolimus was initiated following transplantation, maintaining the patient on a low tacrolimus target (3\u20135\u00a0\u03bcg\/L). Mycophenolate mofetil was discontinued after 8\u2009weeks due to neutropenia and the patient was kept on tacrolimus as monotherapy. Five years posttransplant the patient developed acute onset of neurological symptoms, consisting of ataxia, lack of voluntary coordination, balance, aphasia and dysphagia, and diplopia. She recovered without neurological deficits within 6\u2009weeks. Extensive evaluation revealed no pathology. To avoid a possible a component of tacrolimus\u2010induced cerebral vasoconstriction, the immunosuppressive therapy was changed to everolimus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven years posttransplant, the patient has experienced no serious infections, no rejections, and had excellent graft function, and no de novo donor\u2010specific antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present results indicate that low\u2010dose immunosuppressive therapy after renal transplantation with low immunological risk should be considered for patients with Schimke immuno\u2010osseous dysplasia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14495","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T06:46:16Z","timestamp":1681368376000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Successful low\u2010dose immunotherapy after kidney transplantation in a 10\u2010year\u2010old girl with Schimke immuno\u2010osseous dysplasia"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7294-0697","authenticated-orcid":false,"given":"Stine H\u00f8yer","family":"Finsen","sequence":"first","affiliation":[{"name":"Department of Nephrology Odense University Hospital  Odense Denmark"},{"name":"Department of Cardiovascular and Renal Research, Institute of Molecular Medicine University of Southern Denmark  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0086-0997","authenticated-orcid":false,"given":"Martin","family":"Tepel","sequence":"additional","affiliation":[{"name":"Department of Nephrology Odense University Hospital  Odense Denmark"},{"name":"Department of Cardiovascular and Renal Research, Institute of Molecular Medicine University of Southern Denmark  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1982-6446","authenticated-orcid":false,"given":"Mette","family":"Neland","sequence":"additional","affiliation":[{"name":"H.C. Andersen Children's Hospital Odense University Hospital  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7038-1652","authenticated-orcid":false,"given":"S\u00f8ren","family":"Rittig","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-878X","authenticated-orcid":false,"given":"Helle Charlotte","family":"Thiesson","sequence":"additional","affiliation":[{"name":"Department of Nephrology Odense University Hospital  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1369\/0022155414558335"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-016-0519-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2008.01013.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5500\/wjt.v4.i4.222"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2009.01036.x"},{"key":"e_1_2_8_7_1","unstructured":"MorimotoM LewisDB L\u00fcckeT BoerkoelCF.Schimke Immunoosseous dysplasia. 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