Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
Add more filters










Database
Type of study
Language
Publication year range
1.
Transplant Proc ; 41(10): 4407-10, 2009 Dec.
Article in English | MEDLINE | ID: mdl-20005409

ABSTRACT

Light-Chain Deposition Disease (LCDD) frequently recurs after renal transplantation, displaying a pernicious course. Herein we have described a 39-year-old Caucasian man with a history of immunoglobulin G-kappa multiple myeloma who failed two chemotherapy regimens, but ultimately responded to the combination of thalidomide, bortezomib, and dexamethasone followed by high-dose melphalan and autologous stem cell transplantation 3 years prior to transplantation, during which time he showed no evidence of persistent or recurrent disease. At 3 days following spousal living related renal transplantation, he displayed a rapid deterioration of renal function requiring dialysis therapy. This episode failed to respond to empiric antirejection therapy including anti-thymocyte globulin, plasmapheresis, and anti-CD20 monoclonal antibody. Increasing evidence suggested recurrence of LCDD, including positive immunofluorescence staining of basement membranes and vessels for kappa light chains as well as free kappa light chains in his urine and serum. Following suspension of sirolimus, he was initiated on and responded to bortezomib (1.3 mg/m(2)) with discontinuation of dialysis within 3 weeks and progressively improving renal function. His maintenance therapy, in addition to six 2-week-long cycles of bortezomib separated by 1-week rest periods, includes cyclosporine (50 mg twice daily), prednisone (10 mg daily), and curcumin (9 g daily). In sum, bortezomib rescue therapy salvaged a spousal renal transplant afflicted with recurrent LCDD.


Subject(s)
Antilymphocyte Serum/therapeutic use , Antineoplastic Agents/therapeutic use , Boronic Acids/therapeutic use , Kidney Transplantation/pathology , Multiple Myeloma/pathology , Paraproteinemias/complications , Pyrazines/therapeutic use , Stem Cell Transplantation , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bortezomib , Humans , Kidney Failure, Chronic/etiology , Kidney Failure, Chronic/surgery , Kidney Transplantation/adverse effects , Male , Melphalan/therapeutic use , Multiple Myeloma/drug therapy , Multiple Myeloma/surgery , Recurrence , Transplantation, Autologous , Treatment Outcome
3.
Medicine (Baltimore) ; 67(4): 199-208, 1988 Jul.
Article in English | MEDLINE | ID: mdl-3393077

ABSTRACT

Successful pregnancy in patients on dialysis is uncommon because of a high rate of infertility and complications. The use of hemodialysis to manage pregnant patients needing dialysis has been well reported. However, to our knowledge, only 2 previous cases of pregnant patients using chronic ambulatory peritoneal dialysis (CAPD) have been reported. We discuss 14 pregnancies in 13 women in whom dialysis was used in the management of their pregnancies. Ten pregnancies were successful. Included are 5 successful pregnancies out of 8 managed with CAPD or chronic cycling peritoneal dialysis (CCPD). In comparing the cases managed with CAPD to those managed with hemodialysis, CAPD seems to offer several advantages. These include a more constant biochemical and extracellular environment for the fetus, higher hematocrit levels, infrequent episodes of hypotension, and no heparin requirement. In addition, intraperitoneal insulin facilitates the management of blood glucose in diabetics, and intraperitoneal magnesium facilitates the management of premature labor. Infection, loss of intraperitoneal volume, and loss of peritoneal clearances for solutes and water were not found to be problems.


Subject(s)
Kidney Failure, Chronic/therapy , Pregnancy Complications/therapy , Renal Dialysis , Adult , Creatinine/metabolism , Female , Humans , Kidney Failure, Chronic/metabolism , Peritoneal Dialysis , Peritoneal Dialysis, Continuous Ambulatory , Pregnancy , Pregnancy Complications/metabolism
SELECTION OF CITATIONS
SEARCH DETAIL
...