Mónica Zuluaga-Quintero

Síndrome hemolítico urémico atípico en un paciente joven con compromiso renal, neurológico, ocular y cardiovascular

We present the case of a 23-year-old man with a 3-month history of headache, loss of vision, loss of appetite, and ocular involvement; ocular damage is not frequently reported in the literature.1,2 In more than half of the patients with aHUS, it is possible to identify the complement mutation or the mutation in other foamy urine. In the previous week, he had been bedridden, with sensory disturbances, oliguria, and dyspnoea. Upon molecules leading to abnormal complement regulation. How-

Insuficiencia respiratoria hipoxémica grave por Pneumocystis jirovecii después de trasplante renal

Pneumonia caused by Pneumocystis jirovecii is an uncommon infection in kidney transplant patients that can have an acute and rapid progression to respiratory failure and death. The period of greatest risk occurs in the first six months after the transplant, and it relates to the high doses of immunosuppression drugs required by patients. However, it may occur late, associated with the suspension of prophylaxis with trimethoprim-sulfamethoxazole.We present two cases of renal transplant patients who had severe hypoxemic respiratory failure due to P. jirovecii six years after transplantation. In addition to steroids, they received treatment with trimethoprim-sulfamethoxazole. One patient died, while the other had clinical recovery, with preservation of the renal graft function.

Malakoplakia after kidney transplantation: Case report and literature review.

Malakoplakia is a granulomatous disease associated with an infectious etiology, usually involving the urinary tract. It reveals itself as a recurrent urinary tract infection (r‐UTI), and in some cases, it is associated with impairment of renal function. Immunosuppression is one of its main associated factors, and it has been increasingly described in patients with solid organ transplantation (SOT), mainly kidney transplantation. Macroscopically, it can form masses and sometimes it may be confused with neoplasia, which is why histological findings are fundamental for the diagnosis. Here, we present a case of bladder malakoplakia, manifested by r‐UTI from Escherichia coli in a patient with renal transplantation, refractory to long‐term antibiotic treatment and reduction in immunosuppression, which resolved after surgical management. We also summarize the clinical characteristics of malakoplakia and compare them with previous reports in the literature on SOT.

Falla respiratoria hipoxemica grave por Pneumocystis jirovecii en postrasplante renal tardío

Pneumonia caused by Pneumocystis jirovecii is an uncommon infection in kidney transplant patients that can have an acute and rapid progression to respiratory failure and death. The period of greatest risk occurs in the first six months after the transplant, and it relates to the high doses of immunosuppression drugs required by patients. However, it may occur late, associated with the suspension of prophylaxis with trimethoprim-sulfamethoxazole.We present two cases of renal transplant patients who had severe hypoxemic respiratory failure due to P. jirovecii six years after transplantation. In addition to steroids, they received treatment with trimethoprim-sulfamethoxazole. One patient died, while the other had clinical recovery, with preservation of the renal graft function.

Dolor epigástrico postural como posible síntoma exclusivo de gastritis por citomegalovirus en pacientes trasplantados renales: presentación de un caso

a enfermedad por citomegalovirus es una entidad con importante morbilidad y mortalidad en pacientes trasplantados de organo solido, que se puede presentar como primoinfeccion o reactivacion y con manifesta- ciones clinicas muy variables. A continuacion se reporta el caso de un paciente con dolor epigastrico intenso postural como sintoma inicial de primoinfeccion por citomegalovirus.

Hemolytic uremic syndrome due to gemcitabine in a young woman with cholangiocarcinoma

Gemcitabine is a medication used to treat various types of malignant neoplasms. Its association with hemolytic uremic syndrome (HUS) has been described in few cases, although these cases have resulted in mortality rates of at least 50%. We report on the case of a 25-year-old patient with cholangiocarcinoma in remission who developed microangiopathic hemolytic anemia with acute anuric renal failure after receiving 5 cycles of gemcitabine chemotherapy; this condition was consistent with HUS caused by the side effects of this drug. The administration of gemcitabine was stopped, and hemodialysis, blood transfusions, plasma exchanges, steroids, doxycycline, and rituximab were used to treat the patient. A favorable outcome was achieved; in particular, hemolysis was controlled, and renal function was completely recovered.