The term “T-regs” is shorthand for “regulatory T-cells”–a subpopulation of T-cells which act to suppress immune system activation and promote tolerance towards self-antigens. Although the existence of T-regs was felt to be controversial up until relatively recently, the…
Dialyzer reactions can be classified into two types: “Type A” and “Type B”.Simplistically stated, one is serious and the other one isn’t. A good pneumonic I recently learned from Dr. Daniel Coyne of Washington University-St. Louis at a…
Basic Clinical Immunology: there are four types of hypersensitivity reactions. Below is a listing of all four types and, since this is a Nephrology Blog, renal examples for each one. Type I Immune Reaction (anaphylactic): Type I hypersensitivity…
Quick review of the autoantibodies that may be useful in the diagnosis and management of patients with lupus-related kidney disease: anti-nuclear antibody (ANA): as well as know from our internal medicine days: very sensitive, but not very specific….
The dilemma: there are a subset of patients with some type of paraproteinemia–e.g., light chain deposition disease or amyloidosis, for instance–which are NEGATIVE by SPEP & UPEP. When there is renal involvement, the diagnosis can potentially be made…
One of the interesting ongoing protocols at the Massachusetts General Hospital Kidney Transplant Program is the combined kidney/bone marrow transplant protocol. The idea here is to transplant both kidney & hematopoeitic stem cells from the same donor, which…
Although the traditional dogma of kidney transplant would state that ABO incompatibility is an absolute contraindication for a kidney transplant, this is changing: there are some overall favorable reports of graft longevity in Japan, where cadaveric kidneys are…
A relatively new immunosuppressant agent–originally approved for treatment of refractory rheumatoid arthritis but now gaining steam as an anti-rejection medication for kidney transplant recipients–is abatacept (marketed under the trade name Orencia by Bristol-Myers-Squibb. Its mechanism of action is…
Identifying the “permeability factor” for patients with FSGS or minimal change disease has been one of the “holy grails” of nephrology, and our inability to identify such a factor has not been for any lack of trying. One…
Post-transplant lymphoproliferative disorder (PTLD) occurs in < 1% of kidney transplant recipients, but can often be a serious complication. In essence, PTLD is a form of lymphoma which occurs due to decreased immune surveillance as a result of...
