Improved Graft Function following Desensitization of Anti-AT1R and Autoantibodies in a Heart Transplant Recipient Negative for Donor-Specific Antibodies with Antibody-Mediated Rejection: A Case Report.

HLA donor-specific antibodies (DSAs) pre and post transplant increase the risk of antibody-mediated rejection (AMR) and lead to poor graft survival. Increasing data exist to support the involvement of non-HLA antibodies in triggering an immunological response. The development of non-HLA antibodies specific for AT1R is associated with poor clinical outcomes in orthotopic heart transplant recipients. This case presents an investigation of non-HLA antibodies in a 56-year-old female heart transplant recipient diagnosed with AMR in the absence of DSAs.

Hip pain in adolescents: results of a cross-sectional study in German pupils and a review of the literature.

AIM: To determine the prevalence of hip pain (HP) in adolescents in East Germany and to evaluate the potential factors associated with HP. DESIGN: Cross-sectional epidemiological study of a total of 2368 pupils (1137 males, 1231 females; age 14.5+/-0.65, range 13-18 y). Demographic data and information on sports activity and consumption of soft legal drugs were obtained using a questionnaire. Physical examination was carried out by school doctors. Odds ratio (OR [95% confidence interval]) was calculated for common factors associated with HP. RESULTS: The prevalence of adolescents suffering from HP was 6.5% (n=151). Pain episodes were reported as occasional in 3.0%. A total of 69 subjects (2.9%) suffered from permanent pain during physical activity. Permanent pain when at rest was reported in 0.5% (n=12). Female subjects, students attending high school, smoking adolescents and adolescents with a consumption of alcoholic beverages had a significantly higher prevalence of HP. HP was associated with a significantly higher prevalence of low back pain and knee pain. The prevalence of pathological findings of the hip was 2.5% (n=60). Factors significantly associated with HP were: female gender (1.9-fold), attending high school (2.1-fold) and consumption of tobacco (1.6-fold). CONCLUSIONS: HP in adolescents seems to be mostly caused by functional disorders. There is a possible association between HP and psychological stress or consumption of legal drugs. Prophylactic measures are necessary in this age group in future.