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Serious duodenitis concomitant with graft dysfunction following renal transplantation
Author(s) -
Suzuki Kotaro,
Saito Kazuo,
Yamagishi Takuya,
Teranishi Junichi,
Noguchi Kazumi,
Makiyama Kazuhide,
Kubota Yoshinobu
Publication year - 2007
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2007.01572.x
Subject(s) - medicine , basiliximab , tacrolimus , surgery , duodenitis , transplantation , hemodialysis , methylprednisolone , renal function , concomitant , gastroenterology , gastritis , stomach
A 48‐year‐old woman underwent a renal transplantation from her sister. The graft functioned immediately. She received induction immunosuppressive therapy, including basiliximab, tacrolimus hydrate, mycophenolate mofetil and methylprednisolone. Her urinary output decreased on the first postoperative morning. Plasma exchange for 3 days and conversion from tacrolimus hydrate to cyclosporine partially improved graft function. Graft biopsies on the fifth postoperative day suggested an acute humoral rejection. On the seventh postoperative day, she experienced high fever, disorientation, hypertension and severe upper abdominal pain with a bulk of bloody stool. Graft function deteriorated again. Gastrointestinal fiberscopy showed severe duodenitis with bleeding. Following seven successive daily plasma exchanges with hemodialysis and reconversion to low dose tacrolimus hydrate, the systematic symptoms and graft function gradually improved. Two years after transplantation, graft function was good with a serum creatinine level of 1.0 mg/dL. The patient did not experience any further gastrointestinal symptoms.