Reactivation of Chagas disease after autologous hematopoietic stem cell transplantation

Abstract Chagas disease (CD) is a protozoan zoonosis caused by Trypanosoma cruzi. Reactivation of CD occurs via drug-induced immunosuppression before and during transplantation. Here, we report the case of a 62-year-old man diagnosed with classic Hodgkin lymphoma who received highly aggressive conditioning chemotherapy before undergoing stem cell transplantation (SCT). The patient tested positive for CD in pre-transplantation evaluation. The patient exhibited persistent fever and elevated C-reactive protein levels before and after SCT, and was treated with antibiotics. Micro-Strout test showed evidence of trypomastigotes and he was treated with benznidazole until tested negative. Post-transplantation seropositive patients should be screened for possible reactivation.

Hemolytic uremic syndrome atypical after kidney transplantation: a case report and literature review / Síndrome hemolítico urémico atípico posterior a trasplante renal: presentación de un caso y revisión de la literatura

Abstract Haemolytic uremic syndrome (HUS) is a clinical entity characterized by the appearance of non-immune hemolytic anemia, thrombocytopenia and acute renal failure. It is a disease belonging to the group of thrombotic microangiopathy (MAT) which are part of thrombotic thrombocytopenic purpura also (PTT) and some other MAT associated with other medical conditions formerly known as secondary MAT. Moreover, the variety known as atypical HUS (aHUS) is an ultra-orphan disease that frequently progresses to chronic renal failure (CRF) and is associated with high morbidity and mortality if not properly treated. If a patient presents its first clinical manifestation of aHUS later receive a cadaveric renal transplant which not only makes it an even more exotic case but involves more complexity in their management is presented.

Resumen El síndrome hemolítico urémico (SHU) es una entidad clínica caracterizada por la aparición de anemia hemolítica no inmune, trombocitopenia e insuficiencia renal aguda. Se trata de una enfermedad perteneciente al grupo de las microangiopatías trombóticas (MAT) de la que hacen parte también la purpura trombocitopénica trombótica (PTT) y algunas otras MAT asociadas a otras condiciones médicas antes conocidas como MAT secundarias. Por otra parte, la variedad conocida como SHU atípico (SHUa) es una patología ultra-huérfana que frecuentemente evoluciona a insuficiencia renal crónica (IRC) y se asocia con elevada morbi-mortalidad si no recibe el tratamiento adecuado. Se examina el caso de un paciente que presenta su primera manifestación clínica de síndrome hemolítico urémico atípico después de trasplante renal cadavérico lo cual no solo lo hace un caso aún más exótico, sino que implica mayor complejidad en su manejo.