No abstract

Leprosy is rarely seen in organ transplant patients; only ten cases of leprosy in organ transplant recipients have been reported. We herein report a Taiwanese renal transplant recipient concomitantly infected with borderline lepromatous leprosy. A 68-year-old male received renal transplantation at Guilin, China, in 2000, and then received immunosuppressive therapy with prednisolone, tacrolimus, and mycophenolate. Three years after transplantation, multiple erythematous tender nodules and plaques over the face and lower limbs developed. Biopsies and histopathological examination confirmed the diagnosis of leprosy. We treated the patient with a multidrug regimen including dapsone, clofazimine, and rifampine since November of 2003 with a good response. Unfortunately, he suffered from a cluster of complications after an accidental fall, finally leading to septic shock and death five months later. In summary, we report a rare case of new-onset leprosy after renal transplantation in Taiwan and suggest leprosy should be listed in the differential diagnosis of unusual skin manifestations in organ transplant patients.

Two novel HLA-DRB1 alleles, DRB1*1443 and DRB1*1351, were identified using a sequence-based typing protocol. DRB1*1443 differed from DRB1*140501 by one single-nucleotide substitution in exon-2 (codon 77, ACC-->GCC), which corresponded to an amino acid change of threonine to alanine. DRB1*1351 was identical to DRB1*1301 but differed by a single-nucleotide substitution at codon 50 (GTG-->TTG), resulting in an amino acid change of valine to leucine. Both new alleles present unique polymorphisms, which have not been seen among other DRB1 alleles and which have no known effect on peptide binding.