Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport / Hemophagocytic syndrome after kidney transplant in a patient with hereditary nephritis. Report of one case
Rev. méd. Chile
;
141(4): 519-524, abr. 2013. ilus, tab
Artigo
em Espanhol
| LILACS
| ID: lil-680474
ABSTRACT
We report a 28-year-old mole with a hereditary nephritis (Alport Syndrome) on hemodialysis for 5 years, who received a kidney graft from a deceased donor. Cyclosporine (CsA), mycophenolate mofetil (MMF) and steroids were prescribed. In thepostoperativeperiod thepatient had thrombophlebitis and diarrhea. A CTsean showed splenomegaly, ascites, bilateral pleural effusion and bowel edema. Laboratory showed hypoalbuminemia, increased C reactive protein (CRP) and panhypogam-maglobulinemia. At day 32 after transplantation, an acute rejection (Banff II b) was diagnosed and treated with methylprednisolone, replacing CsA by tacrolimus. The acute rejection was controlled but six days later, high fever, pancytopenia and hyperferritinemia appeared. A bone marrow smear showed numerous histiocytes and hemophagocytosis. Hemophagocytic syndrome was diagnosed. MMF and tacrolimus were withdrawn and CsA was reinstituted. Fever fell quickly, CPR normalized at 24 hours and white blood cell count at 72 hours. Days later, the concentrations of albumin, immunoglobulins and hematological parameters normalized. The patient was discharged on day 57 after admission in good condition.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Transplante de Rim
/
Linfo-Histiocitose Hemofagocítica
/
Nefrite Hereditária
Tipo de estudo:
Estudo diagnóstico
Limite:
Adulto
/
Humanos
/
Masculino
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2013
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Hospital Naval Almirante Nef/CL
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