Top

Published in:

01-04-2004 | Review

The post-transplant lymphoproliferative disorder—a literature review

Authors: Rokshana Shroff, Lesley Rees

Published in: Pediatric Nephrology | Issue 4/2004

Abstract

The Epstein-Barr virus (EBV)-induced post-transplant lymphoproliferative disorder (PTLD) affects 1%–10% of all paediatric renal transplant recipients. This is a heterogeneous group of conditions characterised by EBV-driven proliferation of B-lymphocytes in the face of impaired T-cell immune surveillance. The risk factors predisposing to PTLD are becoming better understood, but its pathogenesis and myriad of clinical and histological features remain poorly defined. While new treatment modalities are being tried with variable success, regular EBV surveillance and carefully monitored reduction of immunosuppression remain the mainstay of treatment. In this review, we have presented the current knowledge of this increasingly common complication in renal transplant recipients.

Nalesnik M, Demetris AJ, Fung JJ, Randhawa P, Zeevi A (2000) Post-transplantation lymphoproliferative disorder. Available on Transplantation Clinical Management athttp://www.medscape.com

Dharnidharka VR, Sullivan EK, Stablein DM, Tejani AH, Harmon WE (2001) Risk factors for post transplant lymphoproliferative disorder (PTLD) in kidney transplantation: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Transplantation 71:1065–1068PubMed

Funch DP, Brady J, Ko HH, Dreyer NA, Walker AM (2002) Methods and objectives of a large US multicentre case control study of post-transplant lymphoproliferative disorder in renal transplant patients. Recent Results Cancer Res 159:81–88PubMed

Pinkerton CR, Hann I, Weston CL, Mapp T, Wotherspoon A, Hobson R, Kelley DA, Vergani D, Hadzic D, Rees L, Burke M, Thomas JA (2002) Immunodeficiency-related lymphoproliferative disorders: prospective data from the United Kingdom Children’s Cancer Study Group. Br J Hematol 118:456–461CrossRef

Penn I (1998) De novo malignancies in pediatric organ transplant recipients. Pediatr Transplant 2:56–63PubMed

Shapiro R, Nalesnik M, McCauley J, Fedorek S, Jordan ML, Scantelbury VP, Jain A, Vivas C, Ellis D, Lombardozzi-Lane S, Randhawa P, Johnston J, Hakala TR, Simmons RL, Fung JJ, Starzl TE (1999) Posttransplant lymphoproliferative disorders in adult and pediatric renal transplant recipients receiving tacrolimus based immunosuppression. Transplantation 68:1851–1854PubMed

Frizzera G (1992) Atypical lymphoproliferative disorders. In: Knowles DM (ed) Neoplastic hematopathology. Williams and Wilkins, Baltimore, pp 459–461

Reyes J, Green M, Bueno J (1996) Epstein Barr virus associated posttransplant lymphoproliferative disease after intestinal transplantation. Transplant Proc 28:2768PubMed

Chen JM, Barr ML, Chadburn A (1998) Management of lymphoproliferative disorders after cardiac transplantation. Ann Thorac Surg 56:527–531

10.

Boyle GJ, Michaels MG, Webber SA, Knisely AS, Kurland G, Cipriani LA, Griffith BP, Fricker FJ (1997) Post-transplant lymphoproliferative disorders in paediatric thoracic organ recipients. J Pediatr 131:309–313PubMed

11.

Raymond E, Tricottet V, Samuel D, Reynes M, Bismuth H, Misset JL (1999) Epstein Barr virus related hepatic lymphoproliferative disorder after liver transplantation. Cancer 76:1344–1349

12.

Paya CV, Fung JJ, Nalesnik MA, Kieff E, Green M, Gores G, Habermenn TM, Wiesner RH, Swinnen LJ, Woodle ES, Bromberg JS (1999) Epstein Barr virus induced posttransplant lymphoproliferative disorders. Transplantation 68:1517–1525PubMed

13.

Ho M, Jaffe R, Miller G (1988) The frequency of Epstein Barr virus infection and associated lymphoproliferative disease after transplantation and its manifestations in children. Transplantation 45:719–724PubMed

14.

Basgoz N, Preiksatitis JK (1995) Post-transplant lymphoproliferative disorder. Infect Dis Clin North Am 9:901–923PubMed

15.

Herzig KA, Juffs HG, Norris D, Brown AM, Gill D, Hawley CM, Cobcroft R, Petrie JB, Marlton P, Thompson D, Campbell SB, Nicol DL, Johnson DW (2003) A single-centre experience of post-transplant lymphoproliferative disorder. Transpl Int 16:529–536CrossRefPubMed

16.

Shroff R, Trompeter R, Cubitt D, Thaker U, Rees L (2002) Epstein Barr virus monitoring in paediatric renal transplant recipients. Paediatr Nephrol 17:770–775CrossRef

17.

Boubenider S, Hiesse C, Goupy C, Kriaa F, Marchand S, Charpentier B (1997) Incidence and consequences of post-transplantation lymphoproliferative disorders. J Nephrol 10:136–145PubMed

18.

Sokal EM (1997) Early signs and risk factors for the increased incidence of Epstein Barr virus related post-transplant lymphoproliferative disease in paediatric transplant patients treated with tacrolimus. Transplantation 64:1438–1442PubMed

19.

Haque T, Thomas JA, Falk KI, Parratt R, Hunt BJ, Yacoub M, Crawford DH (1996) Transfer of donor EBV in transplanted organs causes lymphoproliferative disease in EBV-seronegative recipients. J Gen Virol 77:1169–1172PubMed

20.

Harwood JS, Gould FK, McMaster A (1999) Significance of Epstein Barr virus status and post-transplant lymphoproliferative disease in paediatric thoracic transplantation. Pediatr Transplant 3:100–105CrossRefPubMed

21.

Shaninian VB, Muirhead N, Jevnikar AM, Leckie SH, Kharkar A, Luke PP, Rizkalla KS, Hollomby DJ, House AA (2003) Epstein Barr virus seronegativity is a risk factor for late onset posttransplant lymphoproliferative disorder in adult renal allograft recipients. Transplantation 75:851–856CrossRefPubMed

22.

Libertiny G, Watson CJ, Gray DW, Welsh KI, Morris PJ (2001) Rising incidence of post-transplant lymphoproliferative disease in kidney transplant recipients. Br J Surg 88:1330–1334CrossRefPubMed

23.

Walker RC, Marshall WF, Strickler JC, Wiesner RH, Velosa JA, Habermann TM, McGregor CG, Paya CV (1995) Pretransplantation assessment of the risk of lymphoproliferative disorder. Clin Infect Dis 20:1346–1353PubMed

24.

Ellis D, Jaffe R, Green M, Janosky JJ, Lombardozzi-Lane S, Shapiro R, Scantelbury V, Vivas C, Jordan M (1999) Epstein-Barr virus related disorders in children undergoing renal transplantation with tacrolimus based immunosuppression. Transplantation 68:997–1003PubMed

25.

Starzl TE, Nalesnik MA, Porter KA (1984) Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet I:583–587CrossRef

26.

Cockfield SM (2001) Identifying the patient at risk for post-transplant lymphoproliferative disorder. Transpl Infect Dis 3:70–78CrossRefPubMed

27.

Nalesnik MA, Jaffe R, Starlz TE, Demetris AJ, Porter K, Burnham JA, Makowka L, Ho M, Locker J (1988) The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosporin A—prednisone immunosuppression. Am J Pathol 133:173–192PubMed

28.

Dharnidharkar VR, Ho Pl, Stablein DM, Harmon WE, Tejani AH (2002) Mycophenolate, tacrolimus and post-transplant lymphoproliferative disorder: a report of the North American Paediatric Renal Transplant Cooperative Study. Pediatr Transplant 5:396–399CrossRef

29.

Shpilberg O, Wilson J, Whiteside TL (1999) Pre-transplant immunological profile and risk factor analysis of post-transplant lymphoproliferative disease development: the results of a nested matched case-control study: The University of Pittsburg PTLD study Group. Leuk Lymphoma 36:109–113PubMed

30.

Shapiro R, Scantelbury VP, Jordan ML, Vivas C, Ellis D, Lombardozzi-Lane S, Gilboa N, Gritsch HA, Irish W, McCauley J, Fung JJ, Hakala TR, Simmons RL, Starlz TE (1999) Pediatric renal transplantation under tacrolimus based immunosuppression 67:299–303

31.

Newell KA, Alonso EM, Kelly SM (1999) Association between liver transplantation for Langerhans cell histiocytosis, rejection and development of post-transplant lymphoproliferative disease in children. J Pediatr 131:98–103

32.

Manez R, Breinig MC, Linden P, Wilson J, Torre-Cisneros J, Kusne S, Dummer S, Ho M (1997) Post-transplant lymphoproliferative disease in primary Epstein Barr virus infection after liver transplantation: the role of cytomegalovirus disease. J Infect Dis 176:1462–1467PubMed

33.

Buda A, Caforio A, Calabrese F, Fagiuoli S, Pevere S, Livi U, Naccarato R, Burra P (2000) Lymphoproliferative disorders in heart transplant recipients: the role of hepatitis C virus and Epstein Barr virus infection. Transpl Int 13:S402–S405CrossRefPubMed

34.

Epstein MA, Achong BG, Barr YM (1964) Virus particles in cultured lymphoblasts from Burkitt lymphoma. Lancet I:702–713CrossRef

35.

Zaia JA (1998) Infections in organ transplant recipients. In: Clinical Virology. Churchill Livingstone

36.

Henle G, Henle W (1979) Seroepidemiology of the virus. In: Epstein MA, Achong BG (eds) The Epstein-Barr virus. Springer-Verlag, Berlin Heidelberg New York, pp 297–310

37.

Ppe JH, Horne MK, Scott W (1968) Transformation of human leucocytes in vitro by infiltrates of a human leukaemia cell line containing herpes-like virus. Int J Cancer 3:857–861PubMed

38.

Sixbey JW, Nedrud JG, Raab-Traub N, Hanes RA, Pagano JS (1984) Epstein Barr virus replication in oropharyngeal epithelial cells. N Engl J Med 310:1225–1228PubMed

39.

Miyashita EM, Yang B, Lam KMC, Crawford DH, Thorley-Lawson DA (1995) A novel form of Epstein Barr viral latency in normal B cells. Cell 80:593–599PubMed

40.

Moss DJ, Wallace LE, Rickinson AB, Epstein MA (1989) Cytotoxic T-cell recognition of Epstein Barr virus infected B-cells: HLA restriction of effector cells reactivated in vitro. Eur J Immunol 11:686–690

41.

Hsieh WS, Lemas MV, Ambinder RF (1999) The biology of Epstein-Barr virus in post-transplant lymphoproliferative disease. Transpl Infect Dis 1:204–212CrossRefPubMed

42.

Tanner JE, Alfieri C (2001) The Epstein-Barr virus and post-transplant lymphoproliferative disease: interplay of immunosuppression, EBV and the immune system in disease pathogenesis. Transpl Infect Dis 3:60–69CrossRefPubMed

43.

Swinnen LJ, Costanzo-Nordin MR, Fischer SG (1990) Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiac transplant recipients. N Engl J Med 323:1723–1727PubMed

44.

Ho M, Breinig MK, Drummer JS (1985) Epstein Barr virus infections and DNA hybridisation studies in post-transplantation lymphomas and lymphoproliferative lesions: the role of primary infections. J Infect Dis 152:876–881PubMed

45.

Holmes RD, Sokol RJ (2002) Epstein Barr virus and post-transplant lymphoproliferative disease. Pediatr Transplant 6:456–464CrossRefPubMed

46.

Ho M (1995) Risk factors and pathogenesis of post-transplant lymphoproliferative disorders. Transplant Proc 27 [Suppl 1]:38–40

47.

Collins MH, Montone KT, Leahey AM, Hodinka RL, Salhany KE, Belchis DA, Tomaszewski JE (2001) Autopsy pathology of pediatric post-transplant lymphoproliferative disorder. Pediatrics 107:E89PubMed

48.

Srivastava T, Zwick DL, Rothberg PG, Warady BA (1999) Post-transplant lymphoproliferative disorder in pediatric renal transplantation. Pediatr Nephrol 13:748–754PubMed

49.

Rees L, Thomas A, Amlot PL (1998) Disappearance of an Epstein-Barr virus-positive post-transplant plasmacytoma with reduction of immunosuppression. Lancet 352:789

50.

Darenkov IA, Marcarelli MA, Basadonna GP, Friedman AL, Lorber KM, Howe JG, Crouch J, Bia MJ, Kliger AS, Lorber MI (1997) Reduced incidence of Epstein-Barr virus associated post-transplant lymphoproliferative disorder using preemptive antiviral therapy. Transplantation 64:848–852PubMed

51.

Davis CL, Harrison KL, McVicar JP, Forg PJ, Bronner MP, Marsh CL (1995) Antiviral prophylaxis and the Epstein Barr virus related post-transplant lymphoproliferative disorder. Clin Transplant 9:53–59PubMed

52.

Dotti G, Fiocchi R, Motta T, Gamba A, Gotti E, Gridelli B, Borle-Manzoni C, Viero P, Remuzzi G, Barbui T, Rambaldi A (2000) Epstein-Barr virus negative lymphoproliferative disorder in long-term survivors after heart, kidney and liver transplant. Transplantation 69:705–706PubMed

53.

Sivaraman P, Lye WC (2001) Epstein-Barr virus associated T-cell lymphomas in solid organ transplant recipients. Biomed Pharmacother 55:366–368CrossRefPubMed

54.

Ambinder RF (2000) Gammaherpes viruses and “hit-and-run” oncogenesis. Am J Pathol 156:127–131

55.

Dockrell DH, Strickler JG, Paya CV (1998) Epstein Barr virus induced T-cell lymphomas in solid organ transplant recipients. Clin Infect Dis 26:180–184PubMed

56.

Nalesnik MA (2002) Clinicopathological characteristics of post-transplant lymphoproliferative disorder. Recent Results Cancer Res 159:9–18PubMed

57.

Lippman SM, Grogan TM, Carry P (1987) Post-transplantation T cell lymphoblastic lymphoma. Am J Med 82:814–818PubMed

58.

Schwab M, Boswald M, Korn K, Rudder H (2000) Epstein-Barr virus in pediatric patients after renal transplantation. Clin Nephrol 53:132–139PubMed

59.

Collins MH, Montone KT, Leahey AM, Hodinka RL, Salhany KE, Kramer DL, Deng C, Tomaszewski JE (2001) Posttransplant lymphoproliferative disease in children. Pediatr Transplant 5:2CrossRef

60.

Shapiro NL, Strocker AM (2001) Adenotonsillar hypertrophy and Epstein Barr virus in pediatric organ transplant recipients. Laryngoscope 111:997–1001PubMed

61.

Martinez AJ, Ahbad-Barmada M (1993) The neuropathology of liver transplantation: comparison of complications in children and adults. Mod Pathol 6:25–29PubMed

62.

Cohen JI (1991) Epstein Barr virus lymphoproliferative disease associated with acquired immunodeficiency. Medicine (Baltimore) 70:137–141

63.

Preiksaitis JK, Diaz-Mitoma F, Miryazan F, Roberts S, Tyrell A (1992) Quantitative oropharyngeal Epstein-Barr virus shedding in renal and cardiac transplant recipients: relationship to immunosuppressive therapy, serological responses and the risk of post-transplant lymphoproliferative disorder J Infect Dis 166:986–994

64.

Hanasono MM, Kamel OW, Chang PP (1995) Detection of Epstein Barr virus in cardiac biopsies of heart transplant patients with lymphoproliferative disorder. Transplantation 60:471–476PubMed

65.

Mihalov ML, Gattuso P, Abraham K (1996) Incidence of post-transplant malignancy amongst 674 solid organ transplant recipients at a single centre. Clin Transpl 10:248–255PubMed

66.

Campe H, Jaeger G, Abou-Ajram C, Nitschko H, Griebel M, Montoya C, Klare B, Koszinowski U (2003) Serial detection of Epstein Barr DNA in sera and peripheral blood leucocyte samples of pediatric renal allograft recipients with persistent mononucleosis-like symptoms defines patients at risk of developing post-transplant lymphoproliferative disease. Pediatr Transplant 7:46–52CrossRefPubMed

67.

Leung E, Shenton BK, Jackson G, Gould FK, Yap C, Talbot D (2002) Use of real-time PCR to measure Epstein-Barr virus genomes in whole blood. J Immunol Methods 270:259–267PubMed

68.

Meerbach A, Gruhn B, Egerer R, Reischl U, Zintl F, Wutzler P (2001) Semiquantitative PCR analysis of Epstein Barr virus DNA in clinical samples of patients with EBV-associated diseases. J Med Virol 65:348–357CrossRefPubMed

69.

Haque T, Thomas A, Parratt R, Hunt BJ, Yacoub MH, Crawford DH (1997) A prospective study in heart and lung transplant recipients correlating persistent Epstein-Barr virus infection with clinical events. Transplantation 64:1028–1034PubMed

70.

Gartner BC, Fischinger J, Schafer H, Einsele H, Roemer K, Lantzsch N (2002) Epstein-Barr viral load as a tool to diagnose and monitor post-transplant lymphoproliferative disease. Recent Results Cancer Res 159:49–54PubMed

71.

Stevens SJ, Verschuuren EA, Pronk I, Der Bij W van, Harmsenne MC, The TH, Meijer CJ, Den Brule AJ van, Middeldorp JM (2001) Frequent monitoring of Epstein-Barr virus load in unfractionated whole blood is essential for early detection of post-transplant lymphoproliferative disease in high-risk patients. Blood 97:1165–1171CrossRefPubMed

72.

Rowe DT, Reyes LQUJ, Jabbour N (1997) Use of quantitative PCR to measure Epstein-Barr virus genome load in the peripheral blood of paediatric transplant patients with lymphoproliferative disorders. J Microbiol 35:1612–1617

73.

Zingg W, Bossart W, Berli E, Nadal D (1999) Detection and quantification of cell free Epstein-Barr virus by polymerase chain reaction and subsequent DNA enzyme immunoassay. J Virol Methods 79:141–148PubMed

74.

Merlino C, Cavallo R, Bergallo M, Giorgi S, Forgnone F, Re D, Sinesi F, Musso T, Negro Ponzi A (2001) Quantitative PCR in EBV-infected renal transplant patients. New Microbiol 24:223–229PubMed

75.

Rowe M, Lear A, Croom-Carter D (1992) Three pathways of Epstein-Barr gene activation from EBNA-positive latency in B lymphocytes. J Virol 66:122–127PubMed

76.

Kieff E (1996) Epstein Barr virus and its replication. In: Fields BN, Knipe DM, Howley PM (eds) Fields virology, vol 3. Lippincott-Raven, Philadelphia, pp 2343–2349

77.

Darenkov A, Marcarelli MA, Basadonna GP (1997) Reduced incidence of post-transplant lymphoproliferative disease using pre-emptive anti-viral therapy. Transplantation 64:848–852PubMed

78.

Bokenkamp A, Grabensee A, Stoffel-Wagner B, Hasan C, Offner G, Lentze MJ (2002) The beta2-microglobulin/ cystatin C ratio—a potential marker of post-transplant lymphoproliferative disease. Clin Nephrol 58:417–422PubMed

79.

Expert Group on Renal Transplantation (2002) European best practice guidelines for renal transplantation. IV. Long-term management of transplant recipients. IV.6.1. Cancer risk after renal transplantation: posttransplant lymphoproliferative disorder—prevention and management. Nephrol Dial Transplant 17 [Suppl 4]:31–36

80.

Newell KA, Alonso EM, Whitington PF, Bruce DS, Millis JM, Pi JB, Woodle ES, Kelly SM, Koeppen H, Hart J, Rubin CM, Thistlethwaite JR Jr (1996) Posttransplant lymphoproliferative disease in pediatric liver transplantation: interplay between primary Epstein Barr virus infection and immunosuppression. Transplantation 62:370–375PubMed

81.

Morgan AJ, Finerty S, Lovgren K, Scullion FT, Morein B (1988) Recombinant vaccinia virus expressing Epstein Barr virus glycoprotein incorporated into immune-stimulating complexes. J Gen Virol 8:2093–2096

82.

Gu SY (1995) First EBV vaccine trial in humans using recombinant vaccinia virus expressing the major membrane antigen. Dev Biol Stand 84:171–177PubMed

83.

Andersson J, Skoldenberg B, Enrberg I, Britton S, Henle W, Andersson U (1985) Aciclovir treatment in primary Epstein Barr virus infection—a double blind placebo controlled study. Scand J Infect Dis 47:107–111

84.

Yao QY, Ogan R, Rowe M, Wood M, Rickinson AB (1989) Epstein Barr virus infected B-cells persist in the circulation of aciclovir treated virus carriers. Int J Cancer 43:67–72PubMed

85.

Starzl TE, Porter KA, Iwatsuki S (1998) Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet I:583–587

86.

Haque T, Amlot PL, Helling N, Thomas JA, Sweny P, Rolles K, Burroughs AK, Prentice HG, Crawford DH (1998) Reconstitution of EBV specific T-cell immunity in solid organ transplant recipients. J Immunol 160:6204–6209PubMed

87.

Amlot PL (1998) Management of post transplant lymphoproliferative disorder (PTLD). Pediatr Nephrol 12:02SCrossRef

88.

Porcu P, Eisenbeis CF, Pelletier RP, Davies EA, Baiocchi RA, Roychowdhury S, Vourganti S, Nuovo GJ, Marsh WL, Ferketic AK, Henry ML, Ferguson RM, Caligiuri MA (2002) Successful treatment of post-transplantation lymphoproliferative disorder following renal allografting is associated with sustained CD8+ T-cell restoration. Blood 100:2341–2348CrossRefPubMed

89.

Benkerrou M, Jais JP, Leblond V (1998) Anti-B cell monoclonal antibody treatment of severe post-transplant lymphoproliferative disorder: prognosis factors and long-term outcome. Blood 92:3137–3141PubMed

90.

Benkerrou M, Durandy A, Fischer A (1993) Therapy for transplant related lymphoproliferative disease. Hematol Oncol Clin North Am 7:467–471PubMed

91.

Cook RC, Connors JM, Gascoyne RD, Fradet G, Levy RD (1999) Treatment of post-transplant lymphoproliferative disease with Rituximab monoclonal antibody after lung transplantation. Lancet 354:1698–1699PubMed

92.

Faro A (1988) Interferon alfa and its effects on post-transplant lymphoproliferative disorders. Springer Semin Immunopathol 20:425CrossRef

93.

Swinnen LJ, Mullen GM, Carr TJ, Costanzo MR, Fisher RI (1995) Aggressive treatment for post-transplant lymphoproliferation. Blood 86:3333–3337PubMed

94.

Papadopoulos EB, Ladany M, Emanuel D (1994) Infusion of donor leucocytes to treat Epstein Barr virus associated lymphoproliferative disorders after allogenic bone marrow transplant. N Engl J Med 330:1185–1190

95.

Rooney CM, Smith CA, Ng CYC (1995) Infusion of cytotoxic T lymphocytes for the prevention of Epstein Barr induced lymphoma in allogenic transplant recipients. Blood 92:1549–1552

96.

Haque T, Wilkie GM, Taylor C, Amlot PL, Murad P, Iley A, Dombagoda D, Britton KM, Swerdlow AJ, Crawford DH (2002) Treatment of Epstein Barr virus positive post-transplantation lymphoproliferative disease with partly HLA-matched allogenic cytotoxic T-cells. Lancet 360:436–441CrossRefPubMed

97.

Demircin G, Rees L (1997) Retransplantation after post-transplant lymphoproliferative disease. Pediatr Nephrol 11:358–360PubMed

98.

Nathanson S, Debray D, Delarue A, Deschenes G (2002) Long-term survival after post-transplant lymphoproliferative disease in children. Pediatr Nephrol 17:668–672CrossRefPubMed

Title: The post-transplant lymphoproliferative disorder—a literature review
Authors: Rokshana Shroff
Lesley Rees
Publication date: 01-04-2004
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 4/2004
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-003-1392-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The post-transplant lymphoproliferative disorder—a literature review

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2004

Hemichorea with antiphospholipid antibodies in a patient with lupus nephritis

Blood pressure and cardiovascular involvement in children with neurofibromatosis type1

Joint Meeting of the French Society of Pediatric Nephrology and of the French Urologic Study Group in Children, 10 - 12 October 2002, Toulouse, France

Cefepime-induced non-convulsive status epilepticus in a peritoneal dialysis patient

Surveillance of Epstein-Barr virus infection as a risk factor for post-transplant lymphoproliferative disorder in pediatric renal transplant recipients

Acute renal failure associated with Gemella haemolysans pneumonia