Threatening drug-drug interaction in a kidney transplant patient with Coronavirus Disease 2019 (COVID-19).
Identifieur interne : 000066 ( 2020/Analysis ); précédent : 000065; suivant : 000067Threatening drug-drug interaction in a kidney transplant patient with Coronavirus Disease 2019 (COVID-19).
Auteurs : Marilù Bartiromo [Italie] ; Beatrice Borchi [Italie] ; Annarita Botta [Italie] ; Alfredo Bagalà [Italie] ; Gianmarco Lugli [Italie] ; Marta Tilli [Italie] ; Annalisa Cavallo [Italie] ; Brunilda Xhaferi [Italie] ; Roberta Cutruzzulà [Italie] ; Augusto Vaglio [Italie] ; Silvia Bresci [Italie] ; Aida Larti [Italie] ; Alessandro Bartoloni [Italie] ; Calogero Cirami [Italie]Source :
- Transplant infectious disease : an official journal of the Transplantation Society [ 1399-3062 ] ; 2020.
Abstract
During the novel coronavirus pandemic, organ transplant recipients represent a frail susceptible category due to long-term immunosuppressive therapy. For this reason, clinical manifestations may differ from general population and different treatment approaches may be needed. We present the case of a 36-year-old kidney transplanted woman affected by Senior-Loken syndrome diagnosed with COVID-19 pneumonia after a contact with her positive mother. Initial symptoms were fatigue, dry cough and coryza; she never had fever nor oxygen supplementation. Hydroxychloroquine and lopinavir/ritonavir were started, and the antiviral drug was replaced with darunavir/cobicistat after two days for diarrhea. Immunosuppressant levels were closely monitored, and we observed very high tacrolimus trough levels despite initial dose reduction. The patient was left with steroid therapy alone. The peculiarity of clinical presentation and the management difficulties represent the flagship of our case-report. We stress the need for guidelines in transplant recipients with COVID-19 infection with particular regard to the management of therapy.
DOI: 10.1111/tid.13286
PubMed: 32279418
Affiliations:
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Diseases Unit, Careggi University Hospital, Florence, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author><author><name sortKey="Larti, Aida" sort="Larti, Aida" uniqKey="Larti A" first="Aida" last="Larti">Aida Larti</name><affiliation wicri:level="1"><nlm:affiliation>Nephrology Unit, Careggi University Hospital, Florence, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Nephrology Unit, Careggi University Hospital, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author><author><name sortKey="Bartoloni, Alessandro" sort="Bartoloni, Alessandro" uniqKey="Bartoloni A" first="Alessandro" last="Bartoloni">Alessandro Bartoloni</name><affiliation wicri:level="1"><nlm:affiliation>Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author><author><name sortKey="Cirami, Calogero" sort="Cirami, Calogero" uniqKey="Cirami C" first="Calogero" last="Cirami">Calogero Cirami</name><affiliation wicri:level="1"><nlm:affiliation>Nephrology Unit, Careggi University Hospital, Florence, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Nephrology Unit, Careggi University Hospital, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author></analytic><series><title level="j">Transplant infectious disease : an official journal of the Transplantation Society</title><idno type="eISSN">1399-3062</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">During the novel coronavirus pandemic, organ transplant recipients represent a frail susceptible category due to long-term immunosuppressive therapy. For this reason, clinical manifestations may differ from general population and different treatment approaches may be needed. We present the case of a 36-year-old kidney transplanted woman affected by Senior-Loken syndrome diagnosed with COVID-19 pneumonia after a contact with her positive mother. Initial symptoms were fatigue, dry cough and coryza; she never had fever nor oxygen supplementation. Hydroxychloroquine and lopinavir/ritonavir were started, and the antiviral drug was replaced with darunavir/cobicistat after two days for diarrhea. Immunosuppressant levels were closely monitored, and we observed very high tacrolimus trough levels despite initial dose reduction. The patient was left with steroid therapy alone. The peculiarity of clinical presentation and the management difficulties represent the flagship of our case-report. We stress the need for guidelines in transplant recipients with COVID-19 infection with particular regard to the management of therapy.</div></front></TEI><affiliations><list><country><li>Italie</li></country><region><li>Lombardie</li></region><settlement><li>Milan</li></settlement></list><tree><country name="Italie"><noRegion><name sortKey="Bartiromo, Marilu" sort="Bartiromo, Marilu" uniqKey="Bartiromo M" first="Marilù" last="Bartiromo">Marilù Bartiromo</name></noRegion><name sortKey="Bagala, Alfredo" sort="Bagala, Alfredo" uniqKey="Bagala A" first="Alfredo" last="Bagalà">Alfredo Bagalà</name><name sortKey="Bartoloni, Alessandro" sort="Bartoloni, Alessandro" uniqKey="Bartoloni A" first="Alessandro" last="Bartoloni">Alessandro Bartoloni</name><name sortKey="Borchi, Beatrice" sort="Borchi, Beatrice" uniqKey="Borchi B" first="Beatrice" last="Borchi">Beatrice Borchi</name><name sortKey="Botta, Annarita" sort="Botta, Annarita" uniqKey="Botta A" first="Annarita" last="Botta">Annarita Botta</name><name sortKey="Bresci, Silvia" sort="Bresci, Silvia" uniqKey="Bresci S" first="Silvia" last="Bresci">Silvia Bresci</name><name sortKey="Cavallo, Annalisa" sort="Cavallo, Annalisa" uniqKey="Cavallo A" first="Annalisa" last="Cavallo">Annalisa Cavallo</name><name sortKey="Cirami, Calogero" sort="Cirami, Calogero" uniqKey="Cirami C" first="Calogero" last="Cirami">Calogero Cirami</name><name sortKey="Cutruzzula, Roberta" sort="Cutruzzula, Roberta" uniqKey="Cutruzzula R" first="Roberta" last="Cutruzzulà">Roberta Cutruzzulà</name><name sortKey="Larti, Aida" sort="Larti, Aida" uniqKey="Larti A" first="Aida" last="Larti">Aida Larti</name><name sortKey="Lugli, Gianmarco" sort="Lugli, Gianmarco" uniqKey="Lugli G" first="Gianmarco" last="Lugli">Gianmarco Lugli</name><name sortKey="Tilli, Marta" sort="Tilli, Marta" uniqKey="Tilli M" first="Marta" last="Tilli">Marta Tilli</name><name sortKey="Vaglio, Augusto" sort="Vaglio, Augusto" uniqKey="Vaglio A" first="Augusto" last="Vaglio">Augusto Vaglio</name><name sortKey="Xhaferi, Brunilda" sort="Xhaferi, Brunilda" uniqKey="Xhaferi B" first="Brunilda" last="Xhaferi">Brunilda Xhaferi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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