Mycophenolate Mofetil and Pulmonary Fibrosis After Kidney Transplantation: A Case Report
| Autor: | William J. Kane, Chad Stone, Dean Y. Kim, Jason E Denny, Krishna G. Putchakayala, Kazuhiro Takahashi, Pauline Go, Lauren Malinzak, Mohamed Safwan |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pulmonary Fibrosis 030230 surgery Tacrolimus Organ transplantation Mycophenolic acid 03 medical and health sciences Fatal Outcome 0302 clinical medicine Pulmonary fibrosis medicine Humans Kidney transplantation 030203 arthritis & rheumatology business.industry Abnormalities Drug-Induced Articles General Medicine Middle Aged Mycophenolic Acid medicine.disease Kidney Transplantation Surgery Transplantation Respiratory failure Sputum medicine.symptom business Immunosuppressive Agents medicine.drug |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| Popis: | Patient: Male, 50 Final Diagnosis: Pulmonary fibrosis Symptoms: Short of breath Medication: — Clinical Procedure: — Specialty: Transplantology Objective: Adverse events of drug therapy Background: Mycophenolate mofetil (MMF) induced lung disease has been described in only a few isolated reports. We report a case of fatal respiratory failure associated with MMF after kidney transplantation. Case Report: A 50-year-old Hispanic male with a history of end-stage renal disease secondary to hypertension underwent deceased donor kidney transplantation. His preoperative evaluations were normal except for a chest x-ray which showed bilateral interstitial opacities. Tacrolimus and MMF were started on the day of surgery. His postoperative course was uneventful and he was discharged on postoperative day 5. One month later, he presented with shortness of breath and a cough with blood-tinged sputum. His respiratory condition deteriorated rapidly, requiring intubation. Chest computer tomography (CT) demonstrated patchy ground-glass opacities with interlobular septal thickening. Comprehensive pulmonary, cardiac, infectious, and immunological evaluations were all negative. Open lung biopsy revealed extensive pulmonary fibrosis with no evidence of infection. He temporarily improved after discontinuation of tacrolimus and MMF, however, on resuming MMF his respiratory status deteriorated again and he subsequently died from hypoxic respiratory failure. Conclusions: An awareness of pulmonary lung disease due to MMF is important to prevent adverse outcomes after organ transplantation. MMF must be used with utmost care in recipients with underlying lung disease as their pulmonary condition might make them more susceptible to any harmful effects of MMF. |
| Databáze: | OpenAIRE |
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