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Withdrawing mycophenolate mofetil in treating a young kidney transplant recipient with COVID-19
Author(s) -
Dong Chen,
Bo Yang,
Yan Zhang,
Liang Chen,
Lai Wei,
Weijie Zhang,
Xinqiang Wang,
Xiaolin Tong,
Zhishui Chen
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000020481
Subject(s) - medicine , mycophenolate , tacrolimus , pneumonia , renal function , creatinine , kidney transplantation , gastroenterology , kidney , blood urea nitrogen , transplantation , urinary system
Rationale: Coronavirus disease 2019 (COVID-19) is a novel infectious disease and became a global issue. Treatment of COVID-19 especially in solid organ transplant recipients is empirical and controversial, especially the adjustment of the immunosuppressants. Patient concerns: A 29-year-old kidney transplant recipient with the symptoms of COVID-19 pneumonia. Diagnoses: COVID-19 pneumonia after kidney transplantation. Interventions: He was treated with modified immunosuppressants (unchanged dose of tacrolimus and oral corticosteroids while discontinuing mycophenolate mofetil (MMF)), antibiotics, interferon α-2b inhalation and traditional Chinese medicine. Outcomes: He recovered from COVID-19 pneumonia after 29 days of hospitalization. And the renal function (measured as blood urea nitrogen, serum creatinine, and urine protein) returned to normal. Lessons: In certain group of COVID-19 (e.g., mild to moderate cases, young patients without comorbidities), a reduction instead of an overall withdrawal of immunosuppressant in kidney transplant recipients is feasible.

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