Kaposi Sarcoma after Kidney Transplant: A Clinical Case Report
- 1 Department of Nephrology-Dialysis-Renal Transplantation, Ibn Sina University Hospital in Rabat, Rabat, Morocco
- 2 Faculty of Medicine and Pharmacy in Rabat, Mohammed V University, Rabat, Morocco
- 3 Department of Nephrology-Dialysis-Renal Transplantation, Ibn Sina University Hospital in Rabat, Rabat, Morocco
- 4 Department of Nephrology-Dialysis-Renal Transplantation, Ibn Sina University Hospital in Rabat, Rabat, Morocco
- 5 Department of Nephrology-Dialysis-Renal Transplantation, Ibn Sina University Hospital in Rabat, Rabat, Morocco
Abstract
Kaposi sarcoma is a neoplasm caused by human herpesvirus 8 (HHV8) that most commonly affects immunosuppressed patients. The skin is the most affected area, but other sites can be involved such as the lung, digestive tract and lymph nodes. The classical presentation involves a violaceous skin lesion that can be small or hidden, leading to a delay in diagnosis. We report a clinical case of a kidney transplant patient, who presented, 14 months after kidney transplant, with unilateral edema of the inferior member and cutaneous rash misdiagnosed and taken initially for erysipelas. The diagnosis of Kaposi’s sarcoma was retained, on a lymph node biopsy of an inguinal adenopathy. The evolution was marked by a local and general improvement after systemic chemotherapy, reducing Tacrolimus and discontinuation of Mycophenolate mofetil . Graft function remained stable during the follow-up.
- Maluccio, M., Sharma, V., Lagman, M., Vyas, S., Yang, H., Li, B., et al. (2003) Tacrolimus Enhances Transforming Growth factor-β1 Expression and Promotes Tumor Progression. Transplantation, 76, 597-602. https://doi.org/10.1097/01.TP.0000081399.75231.3B
- Lebbé, C., Legendre, C. and Frances, C. (2008) Kaposi Sarcoma in Transplantation. Transplant Reviews, 22, 252-261. https://doi.org/10.1016/j.trre.2008.05.004
- Wendling, J., Francès, C., Thervet, E., Agbalika, F., Morinet, F. Bedrossian, J., et al. (2001) Maladie de Kaposi post-transplantation rénale. Le Courrier de la Transplantation, 1, 78-81.
- Regamey, N., Tamm, M., Wernli, M., Witschi, A., Thiel, G., Cathomas, G., et al. (1998) Transmission of Human Herpesvirus 8 Infection from Renal-Transplant Donors to Recipients. The New England Journal of Medicine, 339, 1358-1363. https://doi.org/10.1056/NEJM199811053391903
- Mourad, G., Serre, J.-E., Alméras, C., Basel, O., Garrigue, V., Pernin, V., et al. (2016) Complications infectieuses et néoplasiques après transplantation rénale. Néphrologie & Thérapeutique, 12, 468-487. https://doi.org/10.1016/j.nephro.2016.06.003
- Sarid, R., Olsen, S.J. and Moore. P.S. (1999) Kaposi’s Sarcoma Associated Herpesvirus: Epidemiology, Virology, and Molecular Biology. Advances in Virus Research, 52: 139-232. https://doi.org/10.1016/S0065-3527(08)60299-7
- Lebbé, C., Euvrard, S., Barrou, B., Pouteil-Noble, C., Garnier, J.L. and Glotz, D. (2006) Sirolimus Conversion for Patients with Post Tranplant Kaposi’s Sarcoma. American Journal of Transplantation, 6, 2164-2168. https://doi.org/10.1111/j.1600-6143.2006.01412.x
- Piselli P., Taborelli, M., Cimaglia, C. and Serraino, D. (2019) Decresed Incidence of Kaposi Sarcooma after Kidney Transplant in Italy and Role of mTOR-Inhibitors: 1997-2016. International Journal of Cancer, 145, 597-598. https://doi.org/10.1002/ijc.32098
- Montaner, S., Sodhi, A., Molinolo, A., Bugge, T.H., Sawai, E.T., et al. (2003) Endothelial Infection with KSHV Genes in Vivo Reveals that vGPCR Initiates Kaposi’s Sarcomagenesis and Can Promote the Tumorigenic Potential of Viral Latent Genes. Cancer Cell, 3, 23-26. https://doi.org/10.1016/S1535-6108(02)00237-4
- Stallone, G., Schena, A., Infante, B., Paolo, S.D., Loverre, A., Maggio G., et al. (2005) Sirolimus for Kaposi’s Sarcoma in Renal-Transplant Recipients. The New England Journal of Medicine, 352, 1317-1323. https://doi.org/10.1056/NEJMoa042831