Non-Hodgkin lymphoma in a kidney transplanted patient with methylmalonic acidemia : Metabolic susceptibility and the role of immunosuppression
© 2024 The Authors. JIMD Reports published by John Wiley & Sons Ltd on behalf of SSIEM..
Methylmalonic acidemia cblB type (MMA cblB) is an autosomal recessive inborn error of amino acid metabolism that results in impaired synthesis of adenosylcobalamin, a cofactor of methylmalonyl-CoA mutase. It presents with episodes of coma, vomiting, hypotonia, metabolic acidosis, and hyperammonemia. End-stage kidney disease is a long-term complication. Treatments include vitamin B12 supplementation, L-carnitine, and a low-protein diet. Liver, kidney, or combined liver-kidney transplantations are promising options, but they are not without complications. We report a patient suffering from MMA cblB who developed end-stage kidney disease at 18 years of age. Kidney transplantation allowed him to recover normal kidney function and good metabolic control. Unfortunately, after two decades, he developed non-Hodgkin lymphoma and severe chemotherapy toxicity which led to his death. The risk of lymphoproliferative diseases is known to increase after solid organ transplantation. However, in MMA, factors including mitochondrial dysfunction and oncometabolites, may further increase the risk of malignancy and drug toxicity. Our report highlights the importance of considering the increased risk of cancer in long-term follow-up of MMA cblB patients, especially after solid organ transplantation. Moreover, when chemotherapy is needed, the increased risk of toxicity and metabolic decompensation should be considered and monitored.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:65 |
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| Enthalten in: |
JIMD reports - 65(2024), 2 vom: 30. März, Seite 56-62 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Burlina, Alberto B [VerfasserIn] |
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| Links: |
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| Themen: |
Case Reports |
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| Anmerkungen: |
Date Revised 07.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1002/jmd2.12411 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369344030 |
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| 520 | |a © 2024 The Authors. JIMD Reports published by John Wiley & Sons Ltd on behalf of SSIEM. | ||
| 520 | |a Methylmalonic acidemia cblB type (MMA cblB) is an autosomal recessive inborn error of amino acid metabolism that results in impaired synthesis of adenosylcobalamin, a cofactor of methylmalonyl-CoA mutase. It presents with episodes of coma, vomiting, hypotonia, metabolic acidosis, and hyperammonemia. End-stage kidney disease is a long-term complication. Treatments include vitamin B12 supplementation, L-carnitine, and a low-protein diet. Liver, kidney, or combined liver-kidney transplantations are promising options, but they are not without complications. We report a patient suffering from MMA cblB who developed end-stage kidney disease at 18 years of age. Kidney transplantation allowed him to recover normal kidney function and good metabolic control. Unfortunately, after two decades, he developed non-Hodgkin lymphoma and severe chemotherapy toxicity which led to his death. The risk of lymphoproliferative diseases is known to increase after solid organ transplantation. However, in MMA, factors including mitochondrial dysfunction and oncometabolites, may further increase the risk of malignancy and drug toxicity. Our report highlights the importance of considering the increased risk of cancer in long-term follow-up of MMA cblB patients, especially after solid organ transplantation. Moreover, when chemotherapy is needed, the increased risk of toxicity and metabolic decompensation should be considered and monitored | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a chemotherapy toxicity | |
| 650 | 4 | |a immunosuppression | |
| 650 | 4 | |a kidney transplantation | |
| 650 | 4 | |a methylmalonic acidemia | |
| 650 | 4 | |a mitochondrial dysfunction | |
| 650 | 4 | |a post‐transplant lymphoproliferative disorders | |
| 700 | 1 | |a Burlina, Alessandro P |e verfasserin |4 aut | |
| 700 | 1 | |a Mignani, Renzo |e verfasserin |4 aut | |
| 700 | 1 | |a Cazzorla, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Gueraldi, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Puma, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Loro, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Baumgartner, Matthias R |e verfasserin |4 aut | |
| 700 | 1 | |a Gragnaniello, Vincenza |e verfasserin |4 aut | |
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