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Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect

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Resumo:Successful kidney transplant improves the quality of life and reduces the mortality risk for most patients when compared to maintenance dialysis. We present the case of a 61-year-old woman with chronic kidney disease stage 5-d who received a deceased donor renal transplant. At 21 months after transplantation she developed early post-transplant diabetes and was diagnosed with Pneumocystis jirovecii pneumonia. Her basal creatinine level was 1.1 mg/dL. The patient was admitted with a 7-day history of fever, productive cough, anorexia and right hand altered mobility and sensibility. She was diagnosed with Aspergillus fumigatus pneumonia and the encephalocranial magnetic resonance was suggestive of posterior reversible encephalopathy syndrome, possibly related to high tacrolimus serum levels. Approximately a month later, a renal ultrasound scan and further abdomen computed tomography scan (CT) suggested a tumour and the patient was submitted to right nephrectomy. After discharge, she has been regularly evaluated, maintaining a stable serum creatinine of 2.3 mg/dL, no symptoms associated. This clinical case highlights the myriad of potential complications that transplant recipients are vulnerable to when receiving immunosuppressive therapy.
Autores principais:Melo,Maria João
Outros Autores:Nascimento,Célia; Guerra,José; Gonçalves,João; Santana,Alice
Assunto:Immunosuppressants kidney transplant posterior reversible encephalopathy syndrome
Ano:2015
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
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author Melo,Maria João
author2 Nascimento,Célia
Guerra,José
Gonçalves,João
Santana,Alice
author2_role author
author
author
author
author_facet Melo,Maria João
Nascimento,Célia
Guerra,José
Gonçalves,João
Santana,Alice
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Melo,Maria João\"},{\"Person.name\":\"Nascimento,Célia\"},{\"Person.name\":\"Guerra,José\"},{\"Person.name\":\"Gonçalves,João\"},{\"Person.name\":\"Santana,Alice\"}]
datacite.creators.creator.creatorName.fl_str_mv Melo,Maria João
Nascimento,Célia
Guerra,José
Gonçalves,João
Santana,Alice
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Immunosuppressants
kidney transplant
posterior reversible encephalopathy syndrome
datacite.titles.title.fl_str_mv Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
dc.creator.none.fl_str_mv Melo,Maria João
Nascimento,Célia
Guerra,José
Gonçalves,João
Santana,Alice
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200008
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv Portuguese Journal of Nephrology & Hypertension v.29 n.2 2015
dc.subject.none.fl_str_mv Immunosuppressants
kidney transplant
posterior reversible encephalopathy syndrome
dc.title.fl_str_mv Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Successful kidney transplant improves the quality of life and reduces the mortality risk for most patients when compared to maintenance dialysis. We present the case of a 61-year-old woman with chronic kidney disease stage 5-d who received a deceased donor renal transplant. At 21 months after transplantation she developed early post-transplant diabetes and was diagnosed with Pneumocystis jirovecii pneumonia. Her basal creatinine level was 1.1 mg/dL. The patient was admitted with a 7-day history of fever, productive cough, anorexia and right hand altered mobility and sensibility. She was diagnosed with Aspergillus fumigatus pneumonia and the encephalocranial magnetic resonance was suggestive of posterior reversible encephalopathy syndrome, possibly related to high tacrolimus serum levels. Approximately a month later, a renal ultrasound scan and further abdomen computed tomography scan (CT) suggested a tumour and the patient was submitted to right nephrectomy. After discharge, she has been regularly evaluated, maintaining a stable serum creatinine of 2.3 mg/dL, no symptoms associated. This clinical case highlights the myriad of potential complications that transplant recipients are vulnerable to when receiving immunosuppressive therapy.
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person_str_mv Melo,Maria João
Nascimento,Célia
Guerra,José
Gonçalves,João
Santana,Alice
publishDate 2015
publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
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spelling Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effectMelo,Maria JoãoNascimento,CéliaGuerra,JoséGonçalves,JoãoSantana,AliceImmunosuppressantskidney transplantposterior reversible encephalopathy syndromeopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200008URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200008URLHasVersion2015-06-01Successful kidney transplant improves the quality of life and reduces the mortality risk for most patients when compared to maintenance dialysis. We present the case of a 61-year-old woman with chronic kidney disease stage 5-d who received a deceased donor renal transplant. At 21 months after transplantation she developed early post-transplant diabetes and was diagnosed with Pneumocystis jirovecii pneumonia. Her basal creatinine level was 1.1 mg/dL. The patient was admitted with a 7-day history of fever, productive cough, anorexia and right hand altered mobility and sensibility. She was diagnosed with Aspergillus fumigatus pneumonia and the encephalocranial magnetic resonance was suggestive of posterior reversible encephalopathy syndrome, possibly related to high tacrolimus serum levels. Approximately a month later, a renal ultrasound scan and further abdomen computed tomography scan (CT) suggested a tumour and the patient was submitted to right nephrectomy. After discharge, she has been regularly evaluated, maintaining a stable serum creatinine of 2.3 mg/dL, no symptoms associated. This clinical case highlights the myriad of potential complications that transplant recipients are vulnerable to when receiving immunosuppressive therapy.Sociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology & Hypertension v.29 n.2 2015text/htmlengjournal articlehttp://purl.org/coar/resource_type/c_6501literature
spellingShingle Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
Melo,Maria João
Immunosuppressants
kidney transplant
posterior reversible encephalopathy syndrome
status SINGLETON
subject.fl_str_mv Immunosuppressants
kidney transplant
posterior reversible encephalopathy syndrome
title Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
title_full Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
title_fullStr Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
title_full_unstemmed Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
title_short Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
title_sort Posterior reversible encephalopathy syndrome as a kidney transplant immunosuppressive therapy side effect
topic Immunosuppressants
kidney transplant
posterior reversible encephalopathy syndrome
topic_facet Immunosuppressants
kidney transplant
posterior reversible encephalopathy syndrome
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200008
visible 1