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Case Reports: Rare disease
Extremely delayed-onset post-transplant lymphoproliferative disorder in a renal transplant patient
  1. Ethan Holland1,
  2. Ellery Altshuler2 and
  3. Aaron J Franke2
  1. 1College of Medicine, University of Florida, Gainesville, Florida, USA
  2. 2Internal Medicine, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Ethan Holland; eholland1{at}ufl.edu

Abstract

Post-transplant lymphoproliferative disorder (PTLD) is a rare condition that occurs in patients who have undergone solid organ transplantation. Symptoms at presentation depend on the organs involved. PTLD most commonly occurs in the first year after transplant (early onset) or around 5 years after transplant (late onset). Herein, we report a rare presentation of central nervous system PTLD in an adult who presented with seizures 17 years after renal transplantation. After extensive infectious and transplant-related workup, brain biopsy confirmed the diagnosis of PTLD. The patient was treated with rituximab and high-dose methotrexate. Eighteen months later, the patient had no signs of recurrence. Very late-onset (>10 years) PTLD is rare, but is likely to become more common with more long-term survivors of solid organ transplant. Data are limited but show that the factors associated with very late-onset PTLD are different from early or late-onset PTLD.

  • Transplantation
  • Renal transplantation
  • CNS cancer
  • Immunology

https://doi.org/10.1136/bcr-2022-250625

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    Footnotes

    • Twitter @Dr_AJ_Franke

    • Contributors EA conceived of the idea for the case report and also helped with background research, as well as assisted in the writing of the manuscript. EH was primarily responsible for writing the manuscript and also helped with background research. AJF assisted with writing the manuscript and provided subject matter expertise. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.