Malakoplakia in kidney transplant recipients: Three case reports

Table 1 It shows our recipients' complete blood count and chemistry results at the time of evaluation (abnormal values are highlighted in bold)

Laboratory	Case 1	Case 2	Case 3	Normal range
White blood cell	5100	11.7	5.7	4000-11000/mm3
Hemoglobin	10.4	10.7	8.8	12-16 gr/dL
Platelet count	217000	391000	65000	150000-450000/mm3
Na	138	135	127	136-145 mmol/L
K	5.4	4.2	4.7	3.5-5 mmol/L
Cl	106	100	96	96-106 mmol/L
HCO3-	24	17	21	22-26 mmol/L
Blood urea nitrogen	31.4	24.5	33	6-24 mg/dL
Creatinine	2.74	1.82	2.75	0.7-1.1 mg/dL

Table 2 Depicts the clinical characteristics of recipients with kidney allograft malakoplakia

Ref.	Age (years)	Sex	Native disease	Time after transplant	Prior rejection	Organism	Antibiotic duration	Outcome
Case 1	66	M	HTN	8 months	No	E. coli	8 months	Improved
Case 2	39	F	HTN, DM	33 months	Yes	E. coli	3 months	Improved
Case 3	62	M	HTN, DM	1 month	No	E. coli	6 months	Improved
Vishwajeet et al[10], 2023	49	F	NR	12 years	Yes	E. coli	NR	Improved
Rustom et al[11], 2023	55	M	HTN	5 months	NR	E. coli	Long-term	Improved
Triozzi et al[12], 2022	40	F	Hemolytic uremic syndrome	4 months	No	E. coli	30 days	Improved
Yim et el[7], 2022	33	F	GN	6 months	Yes	E. coli	22 days	Improved
Park et al[13], 2020	59	F	DKD	6 months	NR	NR	Long-term	Improved
Lee et al[14], 2022	59	F	NR	18 months	Yes	E. coli	NR	Improved
Patel et al[15], 2021	45	F	GN	16 months	Yes	E. coli, Klebsiella pneumoniae	Long-term	Improved
Kalimuthu et al[16], 2021	41	F	NR	1 year	NR	Culture negative	NR	NR
Kinsella et al[17], 2021	63	F	NR	7 months	NR	E. coli	3 months	Improved
Kinsella et al[17], 2021	52	F	NR	4 months	NR	E. coli	6 months	Improved
Tan et al[18], 2021	55	F	Lithium	NR	NR	E. coli	4 months	NR
Khojah[19], 2020	74	F	NR	2 years	No	E. coli, Enterobacter aerogenes	Long-term	Improved
Khojah[19], 2020	62	F	NR	6 years	No	Culture-negative	6 months	Improved
Yasin et al[20], 2018	36	F	NR	4 years	NR	E. coli	14 weeks	Improved
Mookerji et al[21], 2018	58	M	Polycystic kidney disease	6 months	Yes	E. coli, Enterobacter cloacae	1 month	Kidney failure
Pirojsakul et al[22], 2015	14	F	Vesico-ureteral reflux	1 year	NR	E. coli	NR	NR
Keitel et al[23], 2014	23	F	GN	36 days	Yes	E. coli	28 days	Kidney failure
Honsova et al[24], 2012	31	F	DKD	12 years	Yes	E. coli, Staphylococcus aureus	NR	Improved
Augusto et al[25], 2008	56	F	Unknown	11 months	No, prior transplant	E. coli	10 weeks	Improved
Puerto et al[26], 2007	45	F	NR	2 years	NR	E. coli	None	Kidney failure
Pusl et al[27], 2006	43	F	DKD	2 years	NR	E. coli	2 months	Improved
McKenzie et al[28], 1996	29	F	GN	8 years	NR	NR	Long-term	Improved
Stern et al[29], 1994	55	F	GN	3 years	No	E. coli	Long-term	Improved
Osborn et al[30], 1977	46	F	Pyelonephritis	15 months	No	E. coli, psoriasis vulgaris	1 month	Improved

DKD: Diabetic kidney disease; DM: Diabetes mellitus; E. coli: Escherichia coli; F: Female; GN: Glomerulonephritis; HTN: Hypertensive kidney disease; M: Male; NR: Not reported.

Table 3 depicts the clinical characteristics of kidney transplant recipients with malakoplakia involving other organs

Ref.	Anatomical location	Age, gender	Native disease	Time after transplant	Prior rejection	Organism
Boo et al[31], 2023	Native kidney	40, F	End stage kidney disease	32 weeks	No	E. coli
Coulibaly et al[32], 2023	Colon	62, M	GN	NR	NR	NR
Biggar et al[6], 1985	Abdominal wall	32, M	Reflux	16 months	Yes	E. coli
Nieto-Ríos et al[33], 2017	Bladder	45, F	Preeclampsia	2 years	NR	E. coli
Graves et al[9], 2014	Bladder	56, F	GN	1 year	Yes	E. coli
Merritt et al[34], 1985	Bladder	64, F	NR	3 years	NR	NR
Deguchi et al[35], 1985	Bladder	22, F	GN	1 year	NR	E. coli, Proteus mirabilis, K. pneumoniae
Sian et al[36], 1981	Bladder	52, F	PKD	17 months	No	NR
Arnesen et al[37], 1977	Bladder	37, F	NR	6 months	No	E. coli, Corynebacterium spp.
Mitchell et al[38], 2019	Gastrointestinal	72, F	FSGS	10 months	NR	NR
Ghaith et al[39], 2018	Gastrointestinal	75, M	DKD, HTN	NR	Yes	NR
Koklu et al[40], 2018	Gastrointestinal	51, F	HTN	11 years	NR	NR
Mousa et al[41], 2017	Gastrointestinal	68, M	NR	NR	NR	NR
Bae et al[42], 2013	Gastrointestinal	55, F	GN	11 years	No	NR
Shah et al[43], 2010	Gastrointestinal	45, M	DKD	3 years	Yes	NR
Yousif et al[44], 2006	Gastrointestinal	40, M	PKD	15 months	NR	E. coli
Berney et al[45], 1999	Gastrointestinal	52, M	PKD	9 years	No	E. coli
Macdonald et al[46], 2019	Groin	48, M	Reflex	5 months	No	E. coli
Afonso et al[47], 2013	Groin	51, M	FSGS	2 years	NR	Providentia spp., Candida albicans
Olivier et al[48], 2022	Groin	70, M	DKD, HTN	2 years	NR	E. coli, Pseudomonas aeruginosa
Lowitt et al[49], 1996	Perineum	51, M	Cervical intraepithelial neoplasia	14 months	NR	Streptococci spp., K. pneumoniae, Enterococcus spp.
Leão et al[50], 2012	Perineum	37, M	Reflux	15 years	Yes	Burkholderia cepacia
Ifudu and Delaney[51], 1994	Prostate	60, M	HTN	1 year	NR	E. coli, Serratia marcescens
Lococo et al[52], 2016	Pulmonary	67, M	NR	1 year	NR	Rhodococcus equi
Biggar et al[6], 1985	Pulmonary	44, M	GN	31 months	NR	E. coli
Addison[53], 1986	Skin (eyelid)	35, M	Pyelonephritis	3.5 years	Yes	E. coli
Lowitt et al[49], 1996	Skin (temple)	67, M	DKD, HTN	1 year	NR	E. coli, Streptococcus spp.
Schwob et al[54], 2015	Tongue	70, M	NR	NR	NR	E. coli

DKD: Diabetic kidney disease; E. coli: Escherichia coli; F: Female; FSGS: Focal segmental glomerulosclerosi; GN: Glomerulonephritis; HTN: Hypertensive kidney disease; K. pneumoniae: Klebsiella pneumoniae; M: Male; NR: Not reported; PKD: Polycystic kidney disease.