Successful Treatment of Plasma Cell-Rich Acute Rejection Using Pulse Steroid Therapy Alone: A Case Report

Table 1

Previous case reports of plasma cell rich acute rejection.

Report	Age/sex	Cadaver/living	Diffuse/focal	Diagnosis after RTx (m)	TG/VR/DSA	ABMR	Medication	Outcome
Chikamoto et al. [5]	16/F	Living	Diffuse	20	−/+/−	−	mPSL, OKT3, DSG	Graft loss
Suzuki et al. [6]	59/M	Cadaver	Unknown	36	−/−/ND	−	mPSL, DSG	Graft loss
Shimizu et al. [7]	45/M	Living	Focal	18	−/−/ND	−	mPSL	Stable
Yoshikawa et al. [8]	37/M	Living	Diffuse	36	−/−/+ (DQ7)	−	mPSL, PEX, IVIG, Rit, DSG	Worsened
Furuya et al. [9]	33/M	Living	Focal	12	−/−/+ (DQ4, 6)	+	mPSL, PEX, IVIG, Rit	Stable
Hasegawa et al. [10]	30/M	Living	Diffuse	18	+/−/+ (DR52)	+	mPSL, IVIG, Rit, OKT3, DSG	Graft loss
Katsuma et al. [11]	56/M	Cadaver	Focal	21	+/−/+ (DR53)	+	mPSL, PEX, IVIG, Rit	Stable
Our case	47/M	Living	Focal	3	−/−/−	−	mPSL	improved

Diffuse infiltration of PCAR was defined as score i3 in Banff classification or described as “Diffuse.” By contrast, less than i2 was described as “Focal.” ND: no data; VR: vascular rejection; RTx: renal transplantation; TG: transplant glomerulitis; DSA: donor-specific antibody; ABMR: antibody-mediated rejection; mPSL: methylprednisolone; PEX: plasma exchange; IVIG: intravenous immunoglobulin; Rit: Rituximab; OKT3: Muromonab-CD3; DSG: deoxyspergualin.