Plasma cell-rich rejection – The enigma revisited: Case report

Plasma cell-rich rejection (PCRR) is a morphological pattern of rejection characterized by the presence of plasma cells constituting at least 10% of the cellular infiltrate. Clinical characteristics, therapeutic options, and its position in the Banff Classification for Allograft Rejection have not b...

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Main Authors: Srikanth Gundlapalli, Sujeeth Reddy Bande, Venkateswar Rao Mulpuru
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2020-01-01
Series:Indian Journal of Transplantation
Subjects:
Online Access:http://www.ijtonline.in/article.asp?issn=2212-0017;year=2020;volume=14;issue=4;spage=377;epage=379;aulast=
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author Srikanth Gundlapalli
Sujeeth Reddy Bande
Venkateswar Rao Mulpuru
author_facet Srikanth Gundlapalli
Sujeeth Reddy Bande
Venkateswar Rao Mulpuru
author_sort Srikanth Gundlapalli
collection DOAJ
description Plasma cell-rich rejection (PCRR) is a morphological pattern of rejection characterized by the presence of plasma cells constituting at least 10% of the cellular infiltrate. Clinical characteristics, therapeutic options, and its position in the Banff Classification for Allograft Rejection have not been clearly defined. Although morphologically discussed in close association with cellular rejection, histopathological advances and better availability of C4d helped us to understand the close relationship with the antibody-mediated rejection. T helper cell 2 predominant cellular infiltration has been identified in recent studies. Rational choices of drugs such as bortezomib have not shown outcomes as expected in various clinical trials. Newer therapeutic options directed at TH2 cytokines which are being tested in other disorders may open up new avenues of therapy. We discuss two cases of PCRR with varied presentation, one early and the other very late in the course of transplantation. Both of our patients had poor graft outcomes despite therapy.
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spelling doaj.art-76a369c045764b73b8154c61019330892022-12-21T19:02:43ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252020-01-0114437737910.4103/ijot.ijot_76_19Plasma cell-rich rejection – The enigma revisited: Case reportSrikanth GundlapalliSujeeth Reddy BandeVenkateswar Rao MulpuruPlasma cell-rich rejection (PCRR) is a morphological pattern of rejection characterized by the presence of plasma cells constituting at least 10% of the cellular infiltrate. Clinical characteristics, therapeutic options, and its position in the Banff Classification for Allograft Rejection have not been clearly defined. Although morphologically discussed in close association with cellular rejection, histopathological advances and better availability of C4d helped us to understand the close relationship with the antibody-mediated rejection. T helper cell 2 predominant cellular infiltration has been identified in recent studies. Rational choices of drugs such as bortezomib have not shown outcomes as expected in various clinical trials. Newer therapeutic options directed at TH2 cytokines which are being tested in other disorders may open up new avenues of therapy. We discuss two cases of PCRR with varied presentation, one early and the other very late in the course of transplantation. Both of our patients had poor graft outcomes despite therapy.http://www.ijtonline.in/article.asp?issn=2212-0017;year=2020;volume=14;issue=4;spage=377;epage=379;aulast=bortezomib in plasma cell-rich rejectiondelayed rejectionmixed rejectionplasma cell-rich rejection
spellingShingle Srikanth Gundlapalli
Sujeeth Reddy Bande
Venkateswar Rao Mulpuru
Plasma cell-rich rejection – The enigma revisited: Case report
Indian Journal of Transplantation
bortezomib in plasma cell-rich rejection
delayed rejection
mixed rejection
plasma cell-rich rejection
title Plasma cell-rich rejection – The enigma revisited: Case report
title_full Plasma cell-rich rejection – The enigma revisited: Case report
title_fullStr Plasma cell-rich rejection – The enigma revisited: Case report
title_full_unstemmed Plasma cell-rich rejection – The enigma revisited: Case report
title_short Plasma cell-rich rejection – The enigma revisited: Case report
title_sort plasma cell rich rejection the enigma revisited case report
topic bortezomib in plasma cell-rich rejection
delayed rejection
mixed rejection
plasma cell-rich rejection
url http://www.ijtonline.in/article.asp?issn=2212-0017;year=2020;volume=14;issue=4;spage=377;epage=379;aulast=
work_keys_str_mv AT srikanthgundlapalli plasmacellrichrejectiontheenigmarevisitedcasereport
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AT venkateswarraomulpuru plasmacellrichrejectiontheenigmarevisitedcasereport