Severe hypogammaglobulinaemia and opportunistic infections after rituximab therapy in a renal transplant recipient

Abstract

Infectious complications are the leading causes of morbidity and mortality among renal transplant recipients. Hypogammaglobulinaemia may develop as a result of immunosuppressive therapy and is associated with an increased risk of opportunistic infections particularly in the 6-month post-transplant period. Rituximab, which is used for antibody-mediated rejection (AMR), may also contribute to the development of hypogammaglobulinaemia via B-cell depletion. Intravenous immunoglobulin replacement may be beneficial in this setting. With the following case report, we aim to increase the awareness of opportunistic infections and severe hypogammaglobulinaemia in renal transplant recipients treated with rituximab for acute AMR. © 2009 The Author. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.