Gastrointestinal Bleeding and Diffuse Skin Thickening as Kaposi Sarcoma Clinical Presentation
A 56-year-old African patient received a kidney from a deceased donor with 4 HLA mismatches in April 2013. He received immunosuppression with basiliximab, tacrolimus, mycophenolate mofetil, and prednisone. Immediate diuresis and a good allograft function were soon observed. Six months later, the ser...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2015/424508 |
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| author | Sara Querido Henrique Silva Sousa Tiago Assis Pereira Rita Birne Patrícia Matias Cristina Jorge André Weigert Teresa Adragão Margarida Bruges Domingos Machado |
| author_facet | Sara Querido Henrique Silva Sousa Tiago Assis Pereira Rita Birne Patrícia Matias Cristina Jorge André Weigert Teresa Adragão Margarida Bruges Domingos Machado |
| author_sort | Sara Querido |
| collection | DOAJ |
| description | A 56-year-old African patient received a kidney from a deceased donor with 4 HLA mismatches in April 2013. He received immunosuppression with basiliximab, tacrolimus, mycophenolate mofetil, and prednisone. Immediate diuresis and a good allograft function were soon observed. Six months later, the serum creatinine level increased to 2.6 mg/dL. A renal allograft biopsy revealed interstitial fibrosis and tubular atrophy grade II. Toxicity of calcineurin inhibitor was assumed and, after a switch for everolimus, renal function improved. However, since March 2014, renal function progressively deteriorated. A second allograft biopsy showed no new lesions. Two months later, the patient was admitted due to anuria, haematochezia with anaemia, requiring 5 units of packed red blood cells, and diffuse skin thickening. Colonoscopy showed haemorrhagic patches in the colon and the rectum; histology diagnosis was Kaposi sarcoma (KS). A skin biopsy revealed cutaneous involvement of KS. Rapid clinical deterioration culminated in death in June 2014. This case is unusual as less than 20 cases of KS with gross gastrointestinal bleeding have been reported and only 6 cases had the referred bleeding originating in the lower gastrointestinal tract. So, KS should be considered in differential diagnosis of gastrointestinal bleeding in some kidney transplant patients. |
| format | Article |
| id | doaj-art-cac84f57fea7437d9a6cb4830fb201ee |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-cac84f57fea7437d9a6cb4830fb201ee2025-02-03T06:07:26ZengWileyCase Reports in Transplantation2090-69432090-69512015-01-01201510.1155/2015/424508424508Gastrointestinal Bleeding and Diffuse Skin Thickening as Kaposi Sarcoma Clinical PresentationSara Querido0Henrique Silva Sousa1Tiago Assis Pereira2Rita Birne3Patrícia Matias4Cristina Jorge5André Weigert6Teresa Adragão7Margarida Bruges8Domingos Machado9Department of Nephrology, Centro Hospitalar do Médio Tejo, Avenida Xanana Gusmão, Apartado 45, 2350-754 Torres Novas, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalDepartment of Nephrology, Centro Hospitalar de Lisboa Ocidental, Avenida Professor Reinaldo dos Santos, 2790-134 Carnaxide, PortugalA 56-year-old African patient received a kidney from a deceased donor with 4 HLA mismatches in April 2013. He received immunosuppression with basiliximab, tacrolimus, mycophenolate mofetil, and prednisone. Immediate diuresis and a good allograft function were soon observed. Six months later, the serum creatinine level increased to 2.6 mg/dL. A renal allograft biopsy revealed interstitial fibrosis and tubular atrophy grade II. Toxicity of calcineurin inhibitor was assumed and, after a switch for everolimus, renal function improved. However, since March 2014, renal function progressively deteriorated. A second allograft biopsy showed no new lesions. Two months later, the patient was admitted due to anuria, haematochezia with anaemia, requiring 5 units of packed red blood cells, and diffuse skin thickening. Colonoscopy showed haemorrhagic patches in the colon and the rectum; histology diagnosis was Kaposi sarcoma (KS). A skin biopsy revealed cutaneous involvement of KS. Rapid clinical deterioration culminated in death in June 2014. This case is unusual as less than 20 cases of KS with gross gastrointestinal bleeding have been reported and only 6 cases had the referred bleeding originating in the lower gastrointestinal tract. So, KS should be considered in differential diagnosis of gastrointestinal bleeding in some kidney transplant patients.http://dx.doi.org/10.1155/2015/424508 |
| spellingShingle | Sara Querido Henrique Silva Sousa Tiago Assis Pereira Rita Birne Patrícia Matias Cristina Jorge André Weigert Teresa Adragão Margarida Bruges Domingos Machado Gastrointestinal Bleeding and Diffuse Skin Thickening as Kaposi Sarcoma Clinical Presentation Case Reports in Transplantation |
| title | Gastrointestinal Bleeding and Diffuse Skin Thickening as Kaposi Sarcoma Clinical Presentation |
| title_full | Gastrointestinal Bleeding and Diffuse Skin Thickening as Kaposi Sarcoma Clinical Presentation |
| title_fullStr | Gastrointestinal Bleeding and Diffuse Skin Thickening as Kaposi Sarcoma Clinical Presentation |
| title_full_unstemmed | Gastrointestinal Bleeding and Diffuse Skin Thickening as Kaposi Sarcoma Clinical Presentation |
| title_short | Gastrointestinal Bleeding and Diffuse Skin Thickening as Kaposi Sarcoma Clinical Presentation |
| title_sort | gastrointestinal bleeding and diffuse skin thickening as kaposi sarcoma clinical presentation |
| url | http://dx.doi.org/10.1155/2015/424508 |
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