Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica

A 28 years old male on chronic hemodialysis for 40 months due to a IgA crescentic glomerulonephritis developed pancytopenia (hematocrit 16%, white blood cell count 3.800 mm³ and platelets 11.000 mm³. The bone marrow aspirate showed erythropoietic hyperplasia. Hemolytic anemia, folate or vitamin B12...

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Autores principales:	Vega S,Jorge, Rodríguez S,María de los Angeles, Vásquez G,Alejandro, Torres F,Carlos
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2004
Materias:	Anemia, aplastic Bone marrow Glomerulonephritis IgA Pancytopenia
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000800012
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spelling	oai:scielo:S0034-988720040008000122014-08-14Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónicaVega S,JorgeRodríguez S,María de los AngelesVásquez G,AlejandroTorres F,Carlos Anemia, aplastic Bone marrow Glomerulonephritis IgA Pancytopenia A 28 years old male on chronic hemodialysis for 40 months due to a IgA crescentic glomerulonephritis developed pancytopenia (hematocrit 16%, white blood cell count 3.800 mm³ and platelets 11.000 mm³. The bone marrow aspirate showed erythropoietic hyperplasia. Hemolytic anemia, folate or vitamin B12 deficiency and paroxysmal nocturnal hemoglobinuria were ruled out. Steroids were given with a transient elevation of red cells and platelets, which lasted only for some weeks. Afterwards, intravenous immunoglobulin was given without benefit. Two months after, a bone marrow biopsy and a bone marrow magnetic resonance imaging showed severe aplasia. Cyclosporine was started with a rapid increase in blood cells count. Eight months later, he received a renal transplant from a cadaveric donor. Immunosupression was achieved with cyclosporine, prednisone and mycofenolate mofetil. The patient required hemodialysis for the first three weeks and a mild acute cellular rejection was treated with methylprednisolone. At discharge, 6 weeks later, serum creatinine was 2.4 mg/dl and creatinine clearance 37.6 ml/min. During the first months after transplant, platelet count and hemoglobin decreased and a bone marrow biopsy showed only mild hypoplasia. Four months after renal transplant the hematocrit was 43%, white blood cell count 6.600 mm³ and platelets, 150.000 mm³ and did not change during the first year of follow up (Rev Méd Chile 2004; 132: 989-94info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.8 20042004-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000800012es10.4067/S0034-98872004000800012
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Anemia, aplastic Bone marrow Glomerulonephritis IgA Pancytopenia
spellingShingle	Anemia, aplastic Bone marrow Glomerulonephritis IgA Pancytopenia Vega S,Jorge Rodríguez S,María de los Angeles Vásquez G,Alejandro Torres F,Carlos Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica
description	A 28 years old male on chronic hemodialysis for 40 months due to a IgA crescentic glomerulonephritis developed pancytopenia (hematocrit 16%, white blood cell count 3.800 mm³ and platelets 11.000 mm³. The bone marrow aspirate showed erythropoietic hyperplasia. Hemolytic anemia, folate or vitamin B12 deficiency and paroxysmal nocturnal hemoglobinuria were ruled out. Steroids were given with a transient elevation of red cells and platelets, which lasted only for some weeks. Afterwards, intravenous immunoglobulin was given without benefit. Two months after, a bone marrow biopsy and a bone marrow magnetic resonance imaging showed severe aplasia. Cyclosporine was started with a rapid increase in blood cells count. Eight months later, he received a renal transplant from a cadaveric donor. Immunosupression was achieved with cyclosporine, prednisone and mycofenolate mofetil. The patient required hemodialysis for the first three weeks and a mild acute cellular rejection was treated with methylprednisolone. At discharge, 6 weeks later, serum creatinine was 2.4 mg/dl and creatinine clearance 37.6 ml/min. During the first months after transplant, platelet count and hemoglobin decreased and a bone marrow biopsy showed only mild hypoplasia. Four months after renal transplant the hematocrit was 43%, white blood cell count 6.600 mm³ and platelets, 150.000 mm³ and did not change during the first year of follow up (Rev Méd Chile 2004; 132: 989-94
author	Vega S,Jorge Rodríguez S,María de los Angeles Vásquez G,Alejandro Torres F,Carlos
author_facet	Vega S,Jorge Rodríguez S,María de los Angeles Vásquez G,Alejandro Torres F,Carlos
author_sort	Vega S,Jorge
title	Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica
title_short	Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica
title_full	Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica
title_fullStr	Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica
title_full_unstemmed	Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica
title_sort	aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica
publisher	Sociedad Médica de Santiago
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000800012
work_keys_str_mv	AT vegasjorge aplasiamedulartratadaexitosamenteconciclosporinaenunpacienteenhemodialisiscronica AT rodriguezsmariadelosangeles aplasiamedulartratadaexitosamenteconciclosporinaenunpacienteenhemodialisiscronica AT vasquezgalejandro aplasiamedulartratadaexitosamenteconciclosporinaenunpacienteenhemodialisiscronica AT torresfcarlos aplasiamedulartratadaexitosamenteconciclosporinaenunpacienteenhemodialisiscronica
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Aplasia medular tratada exitosamente con ciclosporina en un paciente en hemodiálisis crónica

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