COVID-19 outcomes in kidney transplant recipients receiving a combination of sofosbuvir-daclatasvir treatment; a single-center study

Yaghoubi, Fatemeh; Tavakoli, Farnaz; Dalil, Davood; Akhavan, Marjan; Abbasloo, Samira

doi:10.34172/jrip.2023.32130

Cited by 3 publications

(3 citation statements)

References 20 publications

(24 reference statements)

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“…PB19 has been demonstrated as one of the most common opportunistic viral infections during the first year after renal transplantation, right behind CMV and EBV 5 . PB19 tendentiously infects human EPCs, replicates them, and then lyses the EPCs 6,7 . Erythropoiesis pauses for approximately 1 week during the viremic phase, with no significant clinical manifestations.…”

Section: Discussionmentioning

confidence: 99%

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Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature

Yaghoubi,

Dalil,

Tavakoli

et al. 2023

Clinical Case Reports

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Key clinical messagePB19 infection should be considered an uncommon cause of posttransplant anemia in renal transplant recipients, particularly those whose anemia is not associated with common etiologies. IVIG treatment and reduced immunosuppression could be beneficial.AbstractParvovirus B19‐associated relapsing anemia is rare in kidney transplant recipients. Herein, we report a case of relapsed anemia due to parvovirus B19 infection in a 53‐year‐old woman 18 months after kidney transplantation. The patient presented with palpitations, shortness of breath, dizziness, weakness, and lethargy. Early laboratory findings showed a WBC count of 6.000/μL, RBC count of 1.89/μL, hemoglobin (Hb) 3.5 g/dL, hematocrit (Hct) 15%, platelet count 266.000/μL, MCV 89, reticulocyte count 0.8%, and serum iron 221 μg/dL. Upon further evaluation, the RT‐PCR test for BK polyomavirus and cytomegalovirus (CMV) was negative, while the parvovirus B19 RT‐PCR was positive. The patient was treated with blood transfusion and IVIG 25 g daily for 5 days. Two months after discharge, the patient presented, complaining of palpitation, shortness of breath, and dizziness, with RBC 2.7/μL, Hb 6.5 g/dL, Hct 25%, and MCV 85. Again, the CMV RT‐PCR was negative, while the parvovirus B19 RT‐PCR was positive. Tacrolimus and mycophenolic acid were stopped, and IVIG 25 g daily for 5 days was administered. Consequently, her Hb level increased to 9 g/dL, and the patient was discharged with prednisolone 5 mg daily and cyclosporine 50 mg daily instead of tacrolimus. Viral infection, particularly PB19 infection, should be considered in the differential diagnosis of posttransplantation anemia in KTRs. IVIG treatment and modification of immunosuppressive medications are suggested standard therapies for such patients. The function of transplanted kidneys should be carefully monitored during treatment.

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Section: Discussionmentioning

confidence: 99%

“…anemia, ESRD, kidney transplant, parvovirus B19 replicates them, and then lyses the EPCs. 6,7 Erythropoiesis pauses for approximately 1 week during the viremic phase, with no significant clinical manifestations. It begins again with the production of neutralizing antibodies against the virus.…”

Section: Discussionmentioning

confidence: 99%

Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature

Yaghoubi,

Dalil,

Tavakoli

et al. 2023

Clinical Case Reports

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“…Prior CMV infection is the most common viral cause of GBS, presented in 66% of patients 2,6 . Immunosuppressed individuals, including solid organ transplant recipients, are more prone to infections, resulting in higher mortality and morbidity than the general population 7,8 . Although GBS is rare in solid organ transplant patients, CMV‐related GBS has been previously reported in heart, liver, and renal transplant recipients 6,9,10 .…”

Section: Discussionmentioning

confidence: 99%

Guillain–Barre syndrome after antithymocyte globulin administration in a kidney transplant recipient: A case report and literature review

Tavakoli,

Dalil,

Yaghoubi

et al. 2023

Clinical Case Reports

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Key Clinical MessageThis report describes a rare case of developing Guillain–Barre syndrome (GBS) following receiving rabbit antithymocyte globulin (ATG) after kidney transplantation to prevent acute allograft rejection in a 34‐year‐old man. The patient presented severe pain in the right temporomandibular joint, fever, chills, myalgia, polyarthralgia, and bone pain. Twelve hours later, he developed quadriplegia, paresthesia, and a limited range of active motions in all extremities. No antecedent viral or bacterial infection was identified. The EMG/NCV evaluation displayed acute inflammatory sensory‐motor polyneuropathy. After the administration of GBS treatment, the neurologic symptoms started to improve. Over a few days, the reflexes came back completely, and the patient was able to walk. To our knowledge, this is the second case report of ATG‐related GBS after kidney transplantation.

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Multiple fractures due to hungry bone syndrome following parathyroidectomy: a clinical case report and review of literature

Tavakoli,

Yaghoubi,

Dalil

et al. 2024

Clin Diabetes Endocrinol

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Background Hungry bone syndrome (HBS) is defined as prolonged hypocalcemia caused by a sudden decrease in parathyroid hormone (PTH) levels after parathyroidectomy (PTX). Multiple fractures after PTX due to HBS in an end-stage renal disease (ESRD) patient on chronic hemodialysis (HD) are challenging and rare medical conditions presented in this study. Case Presentation A 42-year-old ESRD patient on HD 3 times a week presented to Shariati Hospital, Tehran, Iran, complaining of worsening bone pain and loss of appetite. Laboratory data revealed an intact parathyroid hormone (iPTH) concentration of 2500 pg/mL, an alkaline phosphatase (Alp) level of 4340 IU/L, a phosphorus (P) level of 9 mg/dL, and a calcium (Ca) concentration of 7.2 mg/dL. Sestamibi scintigraphy revealed parathyroid adenoma. The findings suggested tertiary hyperparathyroidism (HPT-III), and the patient was scheduled for total PTX. Approximately one month after surgery, the patient was referred due to convulsions, leg mobility problems, and worsening bone pain. There was bilateral femoral ecchymosis. The Ca concentration was 5.8 mg/dL, and radiological evaluations revealed multiple skeletal fractures. HBS after PTX was suggested for this patient. After several days of hospitalization, he suffered subcutaneous emphysema followed by rib fractures and passed away. Conclusions Multiple fractures after PTX due to HBS following HPT-III in ESRD patients are rare and demanding, highlighting the necessity of timely diagnosis and management of patients with HPT-III. Severe hypocalcemia following PTX can cause skeletal disorders. However, the surgical treatment of parathyroid adenomas may be more important than the risk of complications associated with bone health.

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COVID-19 outcomes in kidney transplant recipients receiving a combination of sofosbuvir-daclatasvir treatment; a single-center study

Cited by 3 publications

References 20 publications

Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature

Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature

Guillain–Barre syndrome after antithymocyte globulin administration in a kidney transplant recipient: A case report and literature review

Multiple fractures due to hungry bone syndrome following parathyroidectomy: a clinical case report and review of literature

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