肾移植术后并发水痘性肺炎、肝炎和胰腺炎一例报告

A case report of varicella pneumonia,hepatitis and pancreatitis secondary to kidney transplantation

回顾性分析1例肾移植术后并发水痘性肺炎、肝炎和胰腺炎患者的临床资料和诊疗经过。患者于肾移植术后1周突发丘疹伴瘙痒,皮肤科会诊和高通量测序诊断为水痘。检查发现同时合并肺炎、肝炎和胰腺炎。采用个体化治疗方案;减少免疫抑制剂用量,监测血药浓度;抗病毒、抗感染和支持治疗;并发症对症治疗,根据指标变化调整用药;及时复查检测指标及免疫抑制剂血药浓度,保护移植肾功能,使患者痊愈。通过总结分析少见的肾移植术后并发症,为肾移植积累临床经验。

A case of varicella pneumonia,hepatitis and pancreatitis after kidney transplantation was retrospectively analyzed.One week after kidney transplantation,the patient had a papule with pruritus,which was diagnosed as varicella by dermatologist as well as high-throughput sequencing.The patient was found to have pneumonia,hepatitis and pancreatitis.The individualized treatment regimen was used,including the dosage reduction of immunosuppressive agents,the blood drug concentration monitoring,antiviral therapy,anti-infection therapy,supportive treatment,and symptomatic alleviation for complications.The treatment was adjusted according to the indicators'variation.The timely review of the indicators and immunosuppressant blood concentration were performed to protect the transplanted kidney function,and the patient recovered in time.This rare case of postoperative complications of kidney transplantation were summarized and analyzed in order to accumulate clinical experience for the treatment of renal transplantation.