{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:57:46Z","timestamp":1753891066192,"version":"3.41.2"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Lupus nephritis in the context of Systemic Lupus Erythematosus (SLE) is characterized by an unpredicted course with remissions and flare-ups. Among others, it remains a significant cause of end-stage kidney disease (ESKD) in relatively young patients. Therapeutic regimens with newer immunosuppressive agents have been introduced in order to control SLE clinical manifestations more efficiently and limit organ damage induced by immune complex formation and sustained inflammation. Treatment is usually long-term, and the cumulative impact of immunosuppression is expressed through the increased frequency of infections and neoplasms. However, if the observed immunity dysregulation is secondary and pharmaceutically induced or there is a pre-existing, primary immunodeficiency that shares common pathogenetic pathways with SLE's autoimmunity is not always clear. Herein, we present the case of a 39-year-old woman, that reached ESKD due to lupus nephritis. After an upper respiratory cytomegalovirus (CMV) infection and concomitant CMV reactivations the investigation revealed significant immunodeficiency. Not long after the initiation of intravenous immunoglobulin (IVIG) administration, patient received a cadaveric kidney transplant. IVIG was continued along with standard immunosuppression so that both recurrent infections and allograft rejection are avoided. Patient is closely monitored, and her post-transplant course is remarkably satisfying so far. ESKD patients with immunodeficiency syndromes should not be excluded by definition from kidney transplantation.<\/jats:p>","DOI":"10.3389\/fmed.2021.665475","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T07:21:10Z","timestamp":1615533670000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Kidney Transplantation in a Patient With Acquired Agammaglobulinemia and SLE. Issues and Challenges"],"prefix":"10.3389","volume":"8","author":[{"given":"Paraskevi","family":"Pavlakou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marios","family":"Papasotiriou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodoros","family":"Ntrinias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Kourakli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adamantia","family":"Bratsiakou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios S.","family":"Goumenos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelos","family":"Papachristou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,3,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1002\/art.39594","article-title":"Risk of end-stage renal disease in patients with lupus nephritis, 1971-2015: a systematic review and Bayesian meta-analysis","volume":"68","author":"Tektonidou","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1002\/art.39849","article-title":"Comparative rates of serious infections among patients with systemic lupus erythematosus receiving immunosuppressive medications","volume":"69","author":"Feldman","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1093\/rheumatology\/kew457","article-title":"Cumulative immunosuppressant exposure is associated with diversified cancer risk among 14 832 patients with systemic lupus erythematosus: a nested case-control study","volume":"56","author":"Hsu","year":"2017","journal-title":"Rheumatology."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/25785826.2019.1628466","article-title":"Systemic lupus erythematosus and immunodeficiency","volume":"42","author":"Sawada","year":"2019","journal-title":"Immunol Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.rbre.2015.07.006","article-title":"Primary immunodeficiency association with systemic lupus erythematosus: review of literature and lessons learned by the Rheumatology Division of a tertiary university hospital at S\u00e3o Paulo, Brazil","volume":"56","author":"Errante","year":"2016","journal-title":"Revista Brasileira de Reumatologia."},{"key":"B6","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1038\/nrrheum.2017.198","article-title":"Autoimmunity and primary immunodeficiency: Two sides of the same coin?","volume":"14","author":"Schmidt","year":"2018","journal-title":"Nat Rev Rheumatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jaci.2009.08.040","article-title":"Shearer. 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