Related Experiment Video
Updated: Nov 29, 2025
09:27
Cell Subtype-specific Analysis of Neuronal Membrane Proteasome in Somatosensory Neurons
Published on: October 10, 2025
292
Leukocytoclastic Vasculitis Associated with Bortezomib Therapy
Thiagarajan Raj Yashwanth1, Raveendran Vairakkani1, Nagalakshmi Dhanapal Srinivasaprasad1
1Department of Nephrology, Government Stanley Medical College, Chennai, Tamil Nadu, India.
Summary
A kidney transplant patient developed unusual leukocytoclastic vasculitis after bortezomib therapy for rejection. This case highlights a rare side effect of this anti-rejection treatment in renal transplant recipients.
Area of Science:
- Nephrology
- Immunology
- Oncology
Background:
- Renal transplantation is a life-saving procedure for end-stage renal disease.
- Graft rejection remains a significant challenge, necessitating potent immunosuppressive and anti-rejection therapies.
- Bortezomib, a proteasome inhibitor, is used in certain refractory rejection protocols.
Observation:
- A 28-year-old male, 10 years post-renal transplant, presented with acute graft dysfunction.
- Graft biopsy confirmed mixed acute cellular (BANFF IIB) and antibody-mediated rejection (C4d-positive).
- The patient developed peripheral neuropathy, varicellosis, and leukocytoclastic vasculitis during bortezomib treatment.
Findings:
- Successful treatment of rejection with methylprednisolone, plasma exchange, and IVIG led to gradual graft function improvement.
- Bortezomib therapy, while part of the anti-rejection protocol, was associated with the development of leukocytoclastic vasculitis.
- This case highlights an unusual adverse event potentially linked to bortezomib in the post-transplant setting.
Implications:
- Clinicians should be vigilant for rare side effects like leukocytoclastic vasculitis during bortezomib therapy in renal transplant patients.
- Further investigation may be warranted to understand the mechanism of bortezomib-induced vasculitis in this context.
- This case underscores the complex interplay between immunosuppression, anti-rejection treatments, and potential adverse events in long-term transplant management.
