![](/images/graphics-bg.png)
Antibody-Mediated Rejection of the Heart in the Setting of Autoimmune Demyelinating Polyneuropathy : A Case Report and Review of the Literature
Joint Authors
Lindley, Kathryn J.
Schilling, Joel
Ravichandran, Ashwin K.
Joseph, Susan M.
Source
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-10-24
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Background.
Antibody-mediated rejection (AMR) is caused by the production of donor-specific antibodies (DSA) which lead to allograft injury in part via complement activation.
The inflammatory demyelinating polyneuropathies (IDP) are inflammatory disorders of the nervous system, involving both cellular and humoral immune mechanisms directed against myelin.
Case Report.
A 58-year-old man five years after heart transplant presented with progressive dyspnea, imbalance, dysphagia, and weakness.
Nerve conduction studies and electromyogram were consistent with IDP.
Plasmapheresis and high-dose steroids resulted in improvement in neurologic symptoms.
Within two weeks, he was readmitted with anasarca and acute renal failure, requiring intravenous furosemide and inotropic support.
Echocardiogram and right heart catheterization revealed reduced cardiac function and elevated filling pressures.
DSA was positive against HLA DR53, and endomyocardial biopsy revealed grade 1R chronic inflammation, with strong capillary endothelial immunostaining for C4d.
Plasmapheresis and intravenous immunoglobulin (IVIG) were initiated.
His anasarca and renal failure subsequently resolved, echocardiogram showed improved function off inotropes, and anti-DR53 MFI was reduced by 57%.
Conclusions.
This is an example of a single immune-mediated process causing concurrent IDP and AMR.
The improvement in cardiac function and neurologic symptoms with plasmapheresis, IVIG, and high-dose steroids argues for a unifying antibody-mediated mechanism.
American Psychological Association (APA)
Lindley, Kathryn J.& Ravichandran, Ashwin K.& Schilling, Joel& Joseph, Susan M.. 2012. Antibody-Mediated Rejection of the Heart in the Setting of Autoimmune Demyelinating Polyneuropathy : A Case Report and Review of the Literature. Case Reports in Cardiology،Vol. 2012, no. 2012, pp.1-4.
https://search.emarefa.net/detail/BIM-487318
Modern Language Association (MLA)
Lindley, Kathryn J.…[et al.]. Antibody-Mediated Rejection of the Heart in the Setting of Autoimmune Demyelinating Polyneuropathy : A Case Report and Review of the Literature. Case Reports in Cardiology No. 2012 (2012), pp.1-4.
https://search.emarefa.net/detail/BIM-487318
American Medical Association (AMA)
Lindley, Kathryn J.& Ravichandran, Ashwin K.& Schilling, Joel& Joseph, Susan M.. Antibody-Mediated Rejection of the Heart in the Setting of Autoimmune Demyelinating Polyneuropathy : A Case Report and Review of the Literature. Case Reports in Cardiology. 2012. Vol. 2012, no. 2012, pp.1-4.
https://search.emarefa.net/detail/BIM-487318
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-487318