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霉酚酸酯导致肾移植患者发生急性胰腺炎。

Acute pancreatitis induced by mycophenolate mofetil in a kidney transplant patient.

作者信息

Einollahi Behzad, Dolatimehr Fardin

机构信息

Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Students' Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

J Nephropharmacol. 2015 Feb 18;4(2):72-74. eCollection 2015.

Abstract

Acute pancreatitis is a rare life-threatening complication in patients after kidney transplantation. Here we described a 56-year-old man who had received a living related kidney transplant for an end-stage renal disease. In his regular follow-up, his serum creatinine was gradually increased and he underwent an allograft biopsy, which revealed an interstitial nephritis/tubular atrophy grade II. Mycophenolate mofetil (MMF) was prescribed to control chronic allograft nephropathy. He presented with complaints of severe abdominal pain, vomiting, loss of appetite and fever requiring hospital admission twelve days later. Acute pancreatitis was diagnosed on the basis of laboratory data and imaging findings during hospital admission. There was no history of alcohol consumption in our patient. Unfortunately he died one week later and autopsy findings demonstrated acute necrotizing pancreatitis. The bladder drainage of this patients was normal. Laboratory findings in this patient did not endorse infections and other possibilities regarding the etiology of acute pancreatitis in this patient. Therefore, we concluded that acute pancreatitis in near the patient was induced by drugs and basis on our evidence, MMF is the most important suspect. This study suggests that acute pancreatitis can be considered as a side effect of MMF.

摘要

急性胰腺炎是肾移植患者罕见的危及生命的并发症。在此,我们描述了一名56岁男性,他因终末期肾病接受了亲属活体肾移植。在定期随访中,他的血清肌酐逐渐升高,随后接受了移植肾活检,结果显示为II级间质性肾炎/肾小管萎缩。给予霉酚酸酯(MMF)以控制慢性移植肾肾病。12天后,他因严重腹痛、呕吐、食欲不振和发热前来就诊并住院。根据住院期间的实验室检查数据和影像学检查结果诊断为急性胰腺炎。我们的患者无饮酒史。不幸的是,他一周后死亡,尸检结果显示为急性坏死性胰腺炎。该患者的膀胱引流正常。该患者的实验室检查结果不支持感染及急性胰腺炎病因的其他可能性。因此,我们得出结论,该患者近期的急性胰腺炎是由药物引起的,根据我们的证据,MMF是最重要的嫌疑药物。本研究提示,急性胰腺炎可被视为MMF的一种副作用。

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