Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport

We report a 28-year-old male 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 the postoperative period the patient had thrombo...

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Autores principales:	Vega,Jorge, Rodríguez,María De Los Ángeles, Goecke,Helmuth, Santamarina,Mario
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2013
Materias:	Lymphohistiocytosis, hemophagocytic Mycophenolate mofetil Nephritis, hereditary Organ transplantation
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000400014
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spelling	oai:scielo:S0034-988720130004000142013-09-11Síndrome hemofagocítico en un trasplantado renal con síndrome de AlportVega,JorgeRodríguez,María De Los ÁngelesGoecke,HelmuthSantamarina,Mario Lymphohistiocytosis, hemophagocytic Mycophenolate mofetil Nephritis, hereditary Organ transplantation We report a 28-year-old male 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 the postoperative period the patient had thrombophlebitis and diarrhea. A CT sean showed splenomegaly, ascites, bilateral pleural effusion and bowel edema. Laboratory showed hypoalbuminemia, increased C reactive protein (CRP) and panhypogammaglobulinemia. 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 MMF and tacrolimus were withdrawn and CsA was reinstituted.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.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.141 n.4 20132013-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000400014es10.4067/S0034-98872013000400014
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Lymphohistiocytosis, hemophagocytic Mycophenolate mofetil Nephritis, hereditary Organ transplantation
spellingShingle	Lymphohistiocytosis, hemophagocytic Mycophenolate mofetil Nephritis, hereditary Organ transplantation Vega,Jorge Rodríguez,María De Los Ángeles Goecke,Helmuth Santamarina,Mario Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport
description	We report a 28-year-old male 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 the postoperative period the patient had thrombophlebitis and diarrhea. A CT sean showed splenomegaly, ascites, bilateral pleural effusion and bowel edema. Laboratory showed hypoalbuminemia, increased C reactive protein (CRP) and panhypogammaglobulinemia. 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.
author	Vega,Jorge Rodríguez,María De Los Ángeles Goecke,Helmuth Santamarina,Mario
author_facet	Vega,Jorge Rodríguez,María De Los Ángeles Goecke,Helmuth Santamarina,Mario
author_sort	Vega,Jorge
title	Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport
title_short	Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport
title_full	Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport
title_fullStr	Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport
title_full_unstemmed	Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport
title_sort	síndrome hemofagocítico en un trasplantado renal con síndrome de alport
publisher	Sociedad Médica de Santiago
publishDate	2013
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000400014
work_keys_str_mv	AT vegajorge sindromehemofagociticoenuntrasplantadorenalconsindromedealport AT rodriguezmariadelosangeles sindromehemofagociticoenuntrasplantadorenalconsindromedealport AT goeckehelmuth sindromehemofagociticoenuntrasplantadorenalconsindromedealport AT santamarinamario sindromehemofagociticoenuntrasplantadorenalconsindromedealport
_version_	1718436685813907456

Síndrome hemofagocítico en un trasplantado renal con síndrome de Alport

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