A Case of Posttransplant Lymphoproliferative Disease(PTLD) Following Renal Transplantation in a Child

Eun, Byung-Wook; Park, Eun-Sil; Lee, Seong-Yong; Hahn, Hye-Won; Jang, Ju-Young; Park, Kyung-Mi; Kim, Chul-Woo; Kang, Gin-Han; Ko, Jae-Seong; Ha, Il-Soo; Lee, Hoan-Jong; Cheong, Hae-Il; Seo, Jeong-Kee

J Korean Soc Pediatr Nephrol > Volume 6(1); 2002 > Article

J Korean Soc Pediatr Nephrol 2002;6(1): 123-130.

소아에서 신이식후 발생한 Posttransplant Lymphoproliferative Disease(PTLD) 1례

은병욱, 박은실, 이성용, 한혜원, 장주영, 박경미, 김철우, 강진한, 고재성, 하일수, 이환종, 정해일, 서정기

¹서울대학교 의과대학 소아과학교실
²서울대학교 의과대학 소아과학교실
³서울대학교 의과대학 소아과학교실
⁴서울대학교 의과대학 소아과학교실
⁵서울대학교 의과대학 소아과학교실
⁶서울대학교 의과대학 소아과학교실
⁷서울대학교 의과대학 병리학 교실
⁸가톨릭대학교 의과대학 소아과학교실
⁹서울대학교 의과대학 소아과학교실
¹⁰서울대학교 의과대학 소아과학교실
¹¹서울대학교 의과대학 소아과학교실
¹²서울대학교 의과대학 소아과학교실
¹³서울대학교 의과대학 소아과학교실

A Case of Posttransplant Lymphoproliferative Disease(PTLD) Following Renal Transplantation in a Child

Byung-Wook Eun, Eun-Sil Park, Seong-Yong Lee, Hye-Won Hahn, Ju-Young Jang, Kyung-Mi Park, Chul-Woo Kim, Gin-Han Kang, Jae-Seong Ko, Il-Soo Ha, Hoan-Jong Lee, Hae-Il (NULL) Cheong, Jeong-Kee Seo

¹Department of Pediatrics, Seoul National University, College of Medicine
²Department of Pediatrics, Seoul National University, College of Medicine
³Department of Pediatrics, Seoul National University, College of Medicine
⁴Department of Pediatrics, Seoul National University, College of Medicine
⁵Department of Pediatrics, Seoul National University, College of Medicine
⁶Department of Pediatrics, Seoul National University, College of Medicine
⁷Department of Pathology, Seoul National University, College of Medicine
⁸Department of Pediatrics, The Catholic University, College of Medicine
⁹Department of Pediatrics, Seoul National University, College of Medicine
¹⁰Department of Pediatrics, Seoul National University, College of Medicine
¹¹Department of Pediatrics, Seoul National University, College of Medicine
¹²Department of Pediatrics, Seoul National University, College of Medicine
¹³Department of Pediatrics, Seoul National University, College of Medicine

ABSTRACT

Posttransplant lymphoproliferative disease (PTLD) represents a diverse lymphoproliferative disorder ranging front nonspecific reactive hyperplasia to malignant immunoblastic sarcoma developed in a setting of immunosuppression following organ or cellular transplantation. It is often associated with Epstein-Barr virus (EBV) infection and high dose immunosuppression. PTLD after renal transplantation was reported at first in adult in Korea in 1997. In children there have been several cases of PTLD after liver transplantation but PTLD after renal transplantation has not been reported. This is a case report of PTLD developed 4 months after renal transplantation in a 9-year-old boy. The major clinical manifestations were fever, multiple lymph nodes enlargement and blood-tinged stool. EBV was detected by in-situ hybridization in the enlarged cervical lymph node and the colonic tissue. Histological examination revealed B-cell lineage. Use of ganciclovir and reduction of the immunosuppression level resulted in complete remission of PTLD. This is the first pediatric case report of PTLD following renal transplantation in Korea. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 123-30)

Key words: Posttransplant lymphoproliferative disorder | Renal transplantation | Child