Buradasınız

Anasayfa » Content

Wegener Granülomatozlu Olguda Böbrek Nakli Sonrası Erken Dönemde Polimikrobial Enfeksiyonlar

Polymicrobial Infections in the Early Period of Kidney Transplantation in a Case with Wegener’s Granulomatosis

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011
DOI: 
DOI 10.5262/tndt.2011.1001.18

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Wegener’s granulomatosis (WG) is a disorder that causes necrotizing granulomatosis vasculitis particularly of the upper respiratory tract, lung and kidney. A 43-year-old male who had been treated with hemodialysis because of renal insufficiency due to WG underwent live donor renal transplantation. Pulmonary infiltrates were detected on the postoperative 4th day and antibiotic therapy was started with a diagnosis of sepsis and pulmonary infection. Dialysis treatment was also started due to the degradation of renal function for the patient who was intubated during follow-up. Non-invasive mechanical ventilation (BiPAP) treatment was started after extubation. The graft and respiratory function improved during clinical follow-up. Resistant hospital infections, causing respiratory failure and systemic complications, were facilitated by a long history of hospitalization before transplantation, the presence of WG and immunosupression and were successfully treated with a multidisciplinary approach.a
Bookmark/Search this post with
Abstract (Original Language): 
Wegener granülomatozu (WG) özellikle üst solunum yolları, akciğer ve böbrekleri tutan nekrotizan granülomatoz vaskülite yol açan bir hastalıktır. WG’a bağlı renal yetmezlik tanısı ile hemodiyaliz tedavisi alan 43 yaşında erkek hastaya canlı donörden renal transplantasyon uygulandı. Postop 4. günde pulmoner infiltrasyon saptanması üzerine akciğer enfeksiyonu ve sepsis tanılarıyla antibiyoterapi başlandı. Takiplerinde entübe edilen hastaya renal işlevlerinin de bozulmasıyla diyaliz tedavisi başlandı. Ekstübe olduktan sonra non-invaziv mekanik ventilatör (BİPAP) tedavisi başlandı. Takiplerinde graft ve solunum işlevleri düzeldi. Transplantasyon öncesi hastanede uzun yatış öyküsü, WG varlığı ve immünsupresyonun kolaylaştırdığı sistemik komplikasyonlara ve solunum yetmezliğine neden olan dirençli hastane enfeksiyonu multidisipliner yaklaşımla başarıyla tedavi edildi.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_20_pp_99-103.pdf
  • 1
99-103
  • Turkish

REFERENCES

References: 

1. DeRemee RA: Pulmonary vasculitis. In: Fishman AP (ed).
Fishman’s pulmonary diseases and disorders. New-York: Mac-
Graw-Hill Companies, 1998; 1357-1374
2. Rubin LJ: Pulmonary vasculitis and primary pulmonary
hypertension. In: Murray JF, Nadel JA (eds). Textbook of
Respiratory Medicine. Philadelphia: WB Saunders Company, 2000;
1533-1556
3. DeRemee RA: Pulmonary vasculitis. In: Fishman AP (ed).
Fishman’s pulmonary diseases and disorders. New York: McGraw-
Hill 1997; 1357-1374
4. Cotch MF, Hoffman GS, Yerg DE, Kaufman GI, Targonski P,
Kaslow RA: The epidemiology of Wegener’s granulomatosis:
Estimates of the five-year period prevalence, annual mortality,
geographic disease distribution from population-based data sources.
Arthritis Rheum 1996; 39:87-92
5. Alatas F, Metintas M, Özkan R ve ark: Üç olgu nedeniyle Wegener
granülomatozu. Tüberküloz ve Toraks Derg 2003; 51:440-445
103
Coşkun F ve ark: Böbrek Nakli Sonrası Erken Dönem Enfeksiyon Türk N efroloji D iyaliz ve Transplantasyon D ergisi
Turkish Nephrology, Dialysis and Transplantation Journal
Turk Neph Dial Transpl 2011; 20 (1): 99-103
6. Leavitt RY, Fauci AS, Bioch DA, Michel BA, Hunder GG, Arend
WP, Calabrese LH, Fries JF, Lie JT, Lightfoot RW Jr: The American
College of Rheumatology 1990 criteria fot the classification of
Wegener’s granulomatosis. Arthritis Rheum 1990; 33:1101-1107
7. Arslan H: Solid organ transplantasyonu ve enfeksiyonlar. Turkiye
Klinikleri J Int Med Sci 2007; 3:87-96
8. Uzel S, Özsüt H: Organ transplantasyonu sonrası görülen
enfeksiyonlar ve tedavileri. Klimik Derg 1995; 8:104-108
9. Linares L, Cervera C, Cofán F, Ricart MJ, Esforzado N, Torregrosa V,
Oppenheimer F, Campistol JM, Marco F, Moreno A: Epidemiology
and outcomes of multiple antibiotic-resistant bacterial infection in
renal transplantation. Transplant Proc 2007; 39:2222-2224
10. Akalın H: Böbrek transplantasyonunda enfeksiyon komplikasyonları
Turkiye Klinikleri J Surg Med Sci 2006; 2:70-78
11. Moreno A, Cervera C, Gavalda J, Rovira M, de la Cámara R,
Jarque I, Montejo M, de la Torre-Cisneros J, Miguel Cisneros
J, Fortún J, López-Medrano F, Gurguí M, Muñoz P, Ramos A,
Carratalá J: Bloodstream infections among transplant recipients:
Results of a Nationwide Surveillance in Spain 1. Am J Transplant
2007; 7:2579-2586
12. Arseven O: Tanısal algoritm: Ne, ne zaman? Uçan ES (ed).
Pnömoniler: Bir devin uyanışı, İzmir: Saray Tıp Kitabevi 1996;
225-242
13. Cazzadori A, Perri GD, Todeschini G, Luzzati R, Boschiero L,
Perona G, Concia E: Transbronchial biopsy in the diagnosis of
pulmonary infiltrates in immunocompromised patients. Chest 1995;
107:101-106
14. Cohen J, Hopkin J, Kurtz J: Infectious complications after renal
transplantation. In: Morris PJ (ed). Kidney Transplantation:
Principles and Practise. Philadelphia: WB Saunders Company,
1988; 533-573
15. Ersoy A, Yavuz M, Güllülü M ve ark: Böbrek transplant alıcılarında
akciğer enfeksiyonları. Akciğer Arşivi 2000; 1:48-56
16. Sever MŞ: Posttransplant dönemde gözlenen medikal
komplikasyonlar. Aktüel Tıp Dergisi 1996; 1:57-61
17. Schewior L, Dragun D, Schaeffner E: The challenge of Wegener’s
granulomatosis after kidney transplantation. Transpl Int 2009;
22:503-505
18. Hogan SL, Falk RJ, Chin H, Cai J, Jennette CE, Jennette JC, Nachman
PH: Predictors of relapse and treatment resistance in antineutrophil
cytoplasmic antibody-associated small-vessel vasculitis. Ann Intern
Med 2005; 143:621-631
19. Schmitt WH, Van Der Woude FJ: Organ transplantation in the
vasculitides. Curr Opin Rheumatol 2003; 15:22-28

Thank you for copying data from http://www.arastirmax.com