RESUMO
We report a 30 years old male, recipient of a kidney allograft and treated with azathioprine, who eighteen days after transplantation had a clinically asymptomatic elevation of total bilirubin and alkaline phosphatases. Nineteen months later, he presented with mild ascites, with a total bilirubin of 3.5 mg/dl, alkaline phosphatases of 308 U/L (normal < 170 U/L) and a prothrombin time at 55% of control. A liver biopsy showed sinusoidal and perivenular fibrosis without inflammation, compatible with chronic venous obstruction. Hepatic veno-occlusive disease is an infrequent complication of azathioprine use.
Assuntos
Azatioprina/efeitos adversos , Hepatopatia Veno-Oclusiva/induzido quimicamente , Imunossupressores/efeitos adversos , Falência Renal Crônica/cirurgia , Transplante de Rim , Adulto , Azatioprina/uso terapêutico , Hepatopatia Veno-Oclusiva/diagnóstico , Humanos , Imunossupressores/uso terapêutico , MasculinoRESUMO
After observing a fatal chagasic infection in a renal transplant recipient we investigated Chagas disease in 84 recipients of renal transplants. The indirect hemagglutination test was used for screening and xenodiagnosis followed in positive cases, along with ECG and gastrointestinal X ray series. Nine cases were detected (10%); parasites were found in the blood of 6 of them (66%). No patient had cardiac or gastrointestinal involvement. Patients with a positive serology were treated with nifurtimox (2) or benzonidazol (7); xenodiagnosis every 6 months up to 67 months remains negative in these patients. Blood transfusions are suspected as the mechanism for infection in these cases.
Assuntos
Doença de Chagas/diagnóstico , Transplante de Rim , Adolescente , Adulto , Doença de Chagas/tratamento farmacológico , Doença de Chagas/transmissão , Feminino , Humanos , Tolerância Imunológica , Masculino , Nifurtimox/uso terapêutico , Nitroimidazóis/uso terapêutico , Testes Sorológicos , Reação Transfusional , Tripanossomicidas/uso terapêuticoAssuntos
Hemangioma/complicações , Neoplasias Renais/complicações , Lipoma/complicações , Esclerose Tuberosa/complicações , Adulto , Diagnóstico Diferencial , Feminino , Hemangioma/diagnóstico , Humanos , Neoplasias Renais/diagnóstico , Lipoma/diagnóstico , Radiografia , Renografia por Radioisótopo , Artéria Renal/diagnóstico por imagemRESUMO
Se revisan las etiologias, clinica y evolucion en 5 rupturas renales y 2 rerrupturas, en una serie de 60 trasplantes. Esta complicacion tiene, en nuestra serie, una incidencia del 8.3%, con um 100% de injertos perdidos y sin mortalidad, ya sea el tratamiento efectuado medico o quirurgico.Todas las rupturas de nuestra serie estan relacionadas con rechazos agudos severos.Recomendandose mejoria de las condiciones inmunologicas del binomio donante-receptor y restriccion en el uso de hemodialisis, por considerarse un factor predisponente