Cytomegalovirus pneumonia and duodenal hemorrhage after kidney transplantation:One case report with literature review
-
摘要: 目的:探讨肾移植术后并发巨细胞病毒感染与上消化道出血的临床特征。方法:回顾性分析1例患者于肾移植术后并发巨细胞肺炎同时并发严重十二指肠降部出血的临床资料,并复习有关文献,总结其诊治经验。结果:经紧急行消化道血管造影及栓塞止血后,患者平稳度过危险期,痊愈。结论:肾移植术后合并巨细胞病毒感染与上消化道出血的死亡率高,及时有效的诊治可挽救患者生命,多学科共同协作能取得良好治疗效果。Abstract: Objective:To discuss the clinical features for cytomegalovirus(CMV)infection and upper gastrointestinal(GI)bleeding after kidney transplantation.Method:We have retrospectively analyzed one case as that condition.In this report,patient suffered CMV pneumonia after kidney transplantation,and the life-threatening bleeding from postbulbar duodenal ulcer was occurring.It is rare and danger that two complications,which are both high mortality,occurred in one patient.We discussed the experience for the treatment of this condition with literature review.Result:The patient was successfully saved by emergency transcatheter arterial embolization.Conclusion:For high mortality of CMV infections complicated with upper GI bleeding after kidney transplantation,we must promptly diagnosis and effectively treat this difficult case,and the cooperation of multiple departments is a valid process.
-
-
[1] DE KEYZER K,VAN LAECKE S,PEETERS P,etal.De novo thrombotic microangiopathy induced bycytomegalovirus infection leading to renal allograftloss[J].Am J Nephrol,2010,32:491-496.
[2] 黄樱,王红.肾移植术后巨细胞病毒感染的防治[J].中华器官移植杂志,2005,26:252-253.
[3] CHARFEDDINE K,ZAGHDEN S,KHARRAT M,et al.Infectious complications in kidney transplant re-cipients:a single-center experience[J].TransplantProc,2005,37:2823-2825.
[4] KOTTON C N,KUMAR D,CALIENDO A M,et al.Transplantation Society International CMV Consen-sus Group.International consensus guidelines on themanagement of cytomegalovirus in solid organ trans-plantation[J].Transplantation,2010,89:779-795.
[5] GABARDI S,MAGEE C C,BAROLETTI S A,et al.Efficacy and safety of low-dose valganciclovir for pre-vention of cytomegalovirus disease in renal transplantrecipients:a single-center,retrospective analysis[J].Pharmacotherapy,2004,24:1323-1330.
[6] ARDALAN M R,ETEMADI J,SOMI M H,et al.Upper gastrointestinal bleeding during the firstmonth after renal transplantation in the mycopheno-late mofetil era[J].Transplant Proc,2009,41:2845-2847.
[7] SARKIO S,HALME L,KYLLO¨NEN L,et al.Severegastrointestinal complications after 1,515adult kid-ney transplantations[J].Transpl Int,2004,17:505-510.
[8] CARUCCI L R,LEVINE M S,RUBESIN S E,et al.Upper gastrointestinal tract barium examination ofpostbulbar duodenal ulcers[J].Am J Roentgenol,2004,182:927-930.
[9] ANJIKI H,KAMISAWA T,SANAKA M,et al.En-doscopic hemostasis techniques for upper gastrointes-tinal hemorrhage:a review[J].World J GastrointestEndosc,2010,2:54-60.
[10] VENCLAUSKAS L,BRATLIE S O,ZACHRISSONK,et al.Is transcatheter arterial embolization a saferalternative than surgery when endoscopic therapyfails in bleeding duodenal ulcer[J]Scand J Gastroen-terol,2010,45:299-304.
-
计量
- 文章访问数: 44
- PDF下载数: 80
- 施引文献: 0