Published online Jan 16, 2021. doi: 10.12998/wjcc.v9.i2.469
Peer-review started: August 27, 2020
First decision: November 3, 2020
Revised: November 18, 2020
Accepted: November 29, 2020
Article in press: November 29, 2020
Published online: January 16, 2021
Post-transplant lymphoproliferative disease (PTLD) is the most common malignant tumor that occurs after kidney transplantation in children, and is associated with Epstein-Barr virus (EBV).
We report a case of PTLD that occurred in a 17-year-old female patient at 5 mo post-transplant. The first symptom was abdominal pain accompanied by fever, nausea, and vomiting. EBV-associated monomorphic PTLD with multiple abdominal nodules was diagnosed by pathology, clinical manifestations, imaging results, and the presence of EB-DNA. After successful treatment with rituximab, the abdominal nodules in the spleen and liver disappeared.
Early pathological biopsy to confirm the diagnosis is critical to treatment and prognosis. Reducing immunosuppression and rituximab therapy are effective methods for treating PTLD, but need to be initiated as early as possible.
Core Tip: Post-transplant lymphoproliferative disease (PTLD) is related to Epstein-Barr virus infection, but early onset and monomorphic PTLD in childhood kidney transplantation is rare. This case suggests that virological evaluation must be strengthened before and after kidney transplantation in children, and early pathological biopsy to confirm the diagnosis is critical to treatment and prognosis. Rituximab therapy combined with adjusting the immunosuppressive regimen are effective in pediatric kidney transplantation.