Pegado Helio Milani, Siqueira Adailson, Navarajasegaran Joshua, Benvenuti Luiz Alberto, Castro Claudia Regina Pinheiro, Arrieta Santiago Raul, Gutierrez Paulo Sampaio, Dolhnikoff Marisa, Aiello Vera Demarchi, Jatene Marcelo Biscegli, Azeka Estela
Heart Institute (InCor), University of São Paulo Medical School (FMUSP), São Paulo, Brasil.
Oxford University, Oxford, UK.
Transplant Proc. 2023 Jul-Aug;55(6):1449-1450. doi: 10.1016/j.transproceed.2023.06.003. Epub 2023 Jul 27.
Patients who have undergone organ transplantation are immunosuppressed hosts, leaving them at a higher risk of infections. SARS-COV-2 has been shown to affect heart-transplanted patients. In this case report, we present the case of a 14-year-old heart transplant recipient who developed signs and symptoms of heart failure, along with fatigue, after a COVID-19 infection. An endomyocardial biopsy was performed to diagnose rejection and to evaluate whether this was myocarditis due to SARS-COV-2. The biopsy showed intense acute cellular rejection (3R) and antibody rejection PAMR1 H+ but was negative for the SARS-CoV-2 virus. The patient received organ rejection therapy with high-dose methylprednisolone and human immunoglobulin. After treatment, her heart function recovered, with biopsy investigations showing a lower level of cellular rejection (1R).
接受器官移植的患者是免疫抑制宿主，这使他们面临更高的感染风险。已有研究表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）会影响心脏移植患者。在本病例报告中，我们介绍了一名14岁心脏移植受者的病例，该患者在感染2019冠状病毒病（COVID-19）后出现心力衰竭的体征和症状以及疲劳。进行了心内膜心肌活检以诊断排斥反应，并评估这是否为SARS-CoV-2所致的心肌炎。活检显示有强烈的急性细胞排斥反应（3R）和抗体排斥反应PAMR1 H+，但SARS-CoV-2病毒检测呈阴性。该患者接受了大剂量甲泼尼龙和人免疫球蛋白的器官排斥治疗。治疗后，她的心脏功能恢复，活检检查显示细胞排斥反应水平降低（1R）。
