Antithymocyte globulin
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Antithymocyte globulin Guillain Barre syndrome in a renal transplant patient: case report
A 48-year-old male renal transplant recipient developed Guillain Barre syndrome (GBS) after receiving antithymocyte globulin for acute transplant rejection. The man, who had previously tested positive for cytomegalovirus, received antithymocyte globulin [dosage not stated]; he was also receiving mycophenolate and tacrolimus. He subsequently developed hypersensitivity and bicytopenia, and antithymocyte globulin was discontinued. Four days after antithymocyte globulin treatment, he developed febricula, arthralgia and muscle pain, which progressed rapidly to lower-extremity weakness, and paresis in all four extremities. Dysphonia and dysphagia were also noted, and his creatinine level was 2.5 mg/dL. Electromyography revealed alterations consistent with acute motor demyelinating polyneuropathy, and GBS was diagnosed. The man started treatment with immune globulin and steroids. His symptoms disappeared after 24 hours, with slight motor deficits lasting several weeks; he was subsequently discharged. Author comment: "In this instance, the temporal ratio and the symptoms displayed by the patient on administering the [antithymocyte globulin], as well as an absence of other causes, cause us to think that there is a possible association between [antithymocyte globulin] treatment and subsequent [Guillain Barre syndrome], possibly related to serum sickness." Romero A, et al. Treatment with thymoglobulin as the cause of acute demyelinating polyneuropathy in a renal transplant patient. Nefrologia 29: 369-370, No. 4, 2009 - Spain
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Reactions 9 Jan 2010 No. 1283
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