A CASE REPORT OF IMMUNOSUPRESSION RELATED COMPLICATIONS IN A KIDNEY TRANSPLANTED PATIENT

  • Adrijana Spasovska Vasilova University Clinic of Nephrology, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia
  • Sanja Trajkova University Clinic of Hematology, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia
  • Elena Simonovska University Clinic for Pediatric Diseases, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia
  • Simona Stojanoska Godjoska Institute of Pathology, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia
  • Ana Stojanoska University Clinic of Nephrology, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia
  • Igor Nikolov University Clinic of Nephrology, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia
  • Irena Rambabova Bushljetik University Clinic of Nephrology, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia
  • Lada Trajcheska University Clinic of Nephrology, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia
  • Goce Spasovski University Clinic of Nephrology, "Ss. Cyril and Methodius" University, Faculty of Medicine, Skopje, Republic of North Macedonia

Abstract

Immunosuppressed transplant recipients have a higher rate of prolonged survival with a functioning graft, but also prolonged exposure to complications of chronic immunosuppression. Registry data found cancer to be the third most common cause of death after cardiovascular accidents and infections in these patients. In the following case, we present a kidney transplanted patient, successfully treated for Diffuse large B-cell lymphoma, generalized Herpes Zoster, and CMV infection. The patient was a 60 years-old man with a kidney transplant from a cadaver 5 years ago. After the transplantation, no complications occurred. He regularly referred for medical monitoring, and was adherent to medical treatment and investigations. His long term immunosuppressive therapy consisted of a low dose of corticosteroids, tacrolimus, and mycophenolic acid. The patient presented with acute pain and tenderness all over the abdomen that lasted for a few hours. After CT imagining confirmed intussusception at left colic flexure, urgent surgery was performed. Tissue sampling diagnosed Large B-cell lymphoma. The patient underwent 4 cycles of dose-rationalized R-CHOP therapy with a normal PET scan afterward. Herpes Zoster generalized infection and CMV occurred in two months. Treatment with acyclovir was successful. The regular immunosuppressive regime was re-introduced, consisting only of corticosteroids and sirolimus. The creatinine level remained stable for the next two years, and all subsequent PET scans and CT images were in normal range. The patient remained free of infections as well.


Key wordskidney, transplant, immunosuppression, B-cell lymphoma, malignicy.

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Published
2020-07-06
How to Cite
SPASOVSKA VASILOVA, Adrijana et al. A CASE REPORT OF IMMUNOSUPRESSION RELATED COMPLICATIONS IN A KIDNEY TRANSPLANTED PATIENT. Journal of Morphological Sciences, [S.l.], v. 3, n. 2, p. 37-41, july 2020. ISSN 2545-4706. Available at: <http://jms.mk/jms/article/view/128>. Date accessed: 22 oct. 2020.
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Articles