Keiji Sugiura1,2*, Mariko Sugiura1,2, Morikuni Nishihira4,5, Makoto Tujita4, Kazuharu Uchida4 and Kunio Morozumi3
1Department of Environmental Dermatology and Allergology, Daiichi Clinic, Japan
2Department of Dermatology and Allergy, Masuko Memorial Hospital, Japan
3Department of Nephrology, Masuko Memorial Hospital, Japan
4Department of Renal Transplantation, Masuko Memorial Hospital, Japan
5Department of Nephrology, Tomishiro Central Hospital, Japan
A 24-year-old young female developed Bullous Pemphigoid (BP). This patient received a transplanted kidney from her mother because of chronic renal failure. She developed chronic humoral immune transplant rejection (chronic renal rejection) four months before developing BP, and her BP started at the same time as acute cell-mediated immune graft rejection (acute renal rejection). After one month of BP treatment, her BP showed improvement, but the titer of anti-BP 180 non-collagenous 16a (NC16a) antibody remained in a high range. The recrudescence of her BP would be cause for concern is apprehensive because of the high titer of anti-BP 180 NC16a antibody. Type XVII collagen (BP180) is a common antigen between the skin and kidney. Her BP and the high titer of anti-BP 180 NC16a antibody might be related to the transplant tissue. We were concerned about the recurrence of the BP, and we removed the transplanted kidney. After three weeks of nephrectomy, her skin condition was improved, and the anti-BP 180 NC16a antibody titer was quickly reduced. We present the case of BP in a young female, and six other cases of BP in younger people (less than 30 years old) related to the rejection of a transplanted kidney have been reported.
Bullous pemphigoid; Kidney; Nephrectomy; Rejection; Transplantation; Type XVII collagen
Sugiura K, Sugiura M, Nishihira M, Tujita M, Uchida K, Morozumi K. A Case of Bullous Pemphigoid Related to Allograft Renal Rejection in a Young Female. Ann Clin Case Rep. 2020; 5: 1803.