在一名感染新型冠状病毒肺炎的年轻肾移植受者中停用吗替麦考酚酯：一例病例报告。
Withdrawing mycophenolate mofetil in treating a young kidney transplant recipient with COVID-19: A case report.
作者信息
Chen Dong, Yang Bo, Zhang Yan, Chen Liang, Wei Lai, Zhang Weijie, Wang Xinqiang, Tong Xiaolin, Chen Zhishui
机构信息
Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
Key Laboratory of Organ Transplantation, Ministry of Education, Ministry of Public Health, Chinese Academy of Medical Sciences, Wuhan.
出版信息
Medicine (Baltimore). 2020 Jun 12;99(24):e20481. doi: 10.1097/MD.0000000000020481.
RATIONALE
Coronavirus disease 2019 (COVID-19) is a novel infectious disease and became a global issue. Treatment of COVID-19 especially in solid organ transplant recipients is empirical and controversial, especially the adjustment of the immunosuppressants.
PATIENT CONCERNS
A 29-year-old kidney transplant recipient with the symptoms of COVID-19 pneumonia.
DIAGNOSES
COVID-19 pneumonia after kidney transplantation.
INTERVENTIONS
He was treated with modified immunosuppressants (unchanged dose of tacrolimus and oral corticosteroids while discontinuing mycophenolate mofetil (MMF)), antibiotics, interferon α-2b inhalation and traditional Chinese medicine.
OUTCOMES
He recovered from COVID-19 pneumonia after 29 days of hospitalization. And the renal function (measured as blood urea nitrogen, serum creatinine, and urine protein) returned to normal.
LESSONS
In certain group of COVID-19 (e.g., mild to moderate cases, young patients without comorbidities), a reduction instead of an overall withdrawal of immunosuppressant in kidney transplant recipients is feasible.
原理
2019年冠状病毒病（COVID-19）是一种新型传染病，已成为全球性问题。COVID-19的治疗，尤其是实体器官移植受者的治疗，是经验性的且存在争议，尤其是免疫抑制剂的调整。
患者关注
一名29岁的肾移植受者，出现COVID-19肺炎症状。
诊断
肾移植后COVID-19肺炎。
干预措施
他接受了调整后的免疫抑制剂治疗（他克莫司剂量不变，口服糖皮质激素，同时停用霉酚酸酯（MMF））、抗生素、干扰素α-2b吸入治疗及中药治疗。
结果
住院29天后，他从COVID-19肺炎中康复。肾功能（以血尿素氮、血清肌酐和尿蛋白衡量）恢复正常。
经验教训
在某些COVID-19患者群体中（例如，轻至中度病例、无合并症的年轻患者），肾移植受者减少而非完全停用免疫抑制剂是可行的。
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