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肾移植患者的进行性多灶性白质脑病。

Progressive multifocal leukoencephalopathy in a renal transplant patient.

机构信息

School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, No.291, Zhongzheng Rd., Zhonghe District, New Taipei City, 23561, Taiwan.

出版信息

J Neurovirol. 2019 Aug;25(4):612-615. doi: 10.1007/s13365-019-00749-8. Epub 2019 May 8.

Abstract

End-stage renal disease (ESRD) has a major impact on health and affects more than 600,000 people in the USA. The current mainstay treatments include dialysis and kidney transplantation (KT), and patients who have received KT have a higher quality of life and a lower mortality risk than those on chronic dialysis. Therefore, KT is considered the more preferred treatment modality for patients with ESRD. However, even though KT results in a higher long-term survival rate, the use of immunosuppressants is associated with various complications, including opportunistic infections and malignancies, which may lead to a higher risk of death in the first year after transplantation. Progressive multifocal leukoencephalopathy (PML) is a rare complication following KT, with an incidence of 0.027% in KT recipients. We present a case of PML following immunosuppressant therapy in a patient who received KT.

摘要

终末期肾病(ESRD)对健康有重大影响,影响了美国超过 60 万人。目前的主要治疗方法包括透析和肾移植(KT),接受 KT 的患者比慢性透析患者的生活质量更高,死亡率更低。因此,KT 被认为是 ESRD 患者更优选的治疗方式。然而,尽管 KT 导致长期生存率更高,但免疫抑制剂的使用与各种并发症相关,包括机会性感染和恶性肿瘤,这可能导致移植后第一年的死亡风险更高。进行性多灶性白质脑病(PML)是 KT 后的一种罕见并发症,在 KT 受者中的发病率为 0.027%。我们报告了一例接受 KT 后接受免疫抑制剂治疗的 PML 病例。

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