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.
Threatening drug-drug interaction in a kidney transplant patient with Coronavirus Disease 2019 (COVID-19) / Bartiromo M.; Borchi B.; Botta A.; Bagala A.; Lugli G.; Tilli M.; Cavallo A.; Xhaferi B.; Cutruzzula R.; Vaglio A.; Bresci S.; Larti A.; Bartoloni A.; Cirami C.. - In: TRANSPLANT INFECTIOUS DISEASE. - ISSN 1399-3062. - ELETTRONICO. - (2020), pp. 0-0. [10.1111/tid.13286]
Threatening drug-drug interaction in a kidney transplant patient with Coronavirus Disease 2019 (COVID-19)
Botta A.;Bagala A.;Lugli G.;Tilli M.;Xhaferi B.;Cutruzzula R.;Vaglio A.;Larti A.;Bartoloni A.;Cirami C.
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.File | Dimensione | Formato | |
---|---|---|---|
tid.13286.pdf
Accesso chiuso
Tipologia:
Pdf editoriale (Version of record)
Licenza:
Tutti i diritti riservati
Dimensione
265.89 kB
Formato
Adobe PDF
|
265.89 kB | Adobe PDF | Richiedi una copia |
I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.