Two clinical cases of Novel coronavirus pneumonia (NCP) in renal transplant recipients/ 中华器官移植杂志

Y. Tu, Xiongfei Wu, Feng Liu, Juan Wang, Yu Luo, Zhitao Cai, Rengui Chen, Wenliang Liao, Na Liu, Jin Huang
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引用次数: 6

摘要

目的探讨肾移植受者NCP的临床特点、诊断及预后。方法回顾性分析2例肾移植受者NCP的临床资料。根据临床表现、血常规、炎症因子、细胞免疫、胸部CT及治疗效果,比较肾移植受者与普通NCP患者的诊断和治疗。两名受者均出现低热和中热,初始阶段无咳嗽或疲劳。血常规显示白细胞范围正常,但淋巴细胞计数明显减少,c反应蛋白(CRP)升高,降钙素原(PCT)略高。细胞免疫力极低,胸部CT示双肺多发斑片状磨玻璃影。结果发病1周后,两例患者病情均有明显进展。发病机制和影像学改变与普通NCP患者高度相似。2例患者给予抗病毒药物、停用免疫抑制剂、少量激素维持、静脉滴注丙种球蛋白及呼吸支持等对症支持治疗,避免继发感染。目前,两例患者病情均有明显改善,肾功能稳定。其中一人已经康复出院。结论肾移植受者NCP的临床表现与普通NCP患者基本一致。新型冠状病毒肺炎的治疗虽无既定方法,但停止使用免疫抑制剂,维持中、小剂量激素,积极恢复免疫力,及时给予呼吸支持,是有效的。关键词:肾移植;新型冠状病毒肺炎
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Two clinical cases of Novel coronavirus pneumonia (NCP) in renal transplant recipients/ 中华器官移植杂志
Objective To explore the clinical features, diagnosis and prognosis of renal transplant recipients with NCP. Method The clinical data of 2 cases of kidney transplant recipients with NCP were retrospectively analyzed. Based onclinical manifestations, blood routine, inflammatory factors, cell immunity, chest CT andtherapeutic effects, the diagnosis and treatment of NCP in kidney transplant recipients (5th edition) were compared to that ofordinary NCP patients. Both recipients developed onset of low andmoderate fever, with no cough or fatigue at the initial stage. Blood routine indicated a normal range of leukocytes,buta significant decrease in lymphocyte counts, increased C-reactive protein (CRP) , and slightly higher procalcitonin (PCT) . The cellular immunity was extremely low, and the chest CT showed multiple patchy ground glass shadows in both lungs. Result After 1 week of onset, both patients had significant disease progression. The pathogenesis and imaging changes were highly similar tothatreported in ordinary NCP patients.Two patients were givensymptomatic supportive treatment by antiviral agents, stop uses ofimmunosuppression agents, small amount of hormone maintenance, intravenous drip of gamma globulin andrespiratory support toavoid secondary infections. At present, the condition of both patients is obviously improved, and renal function is stable. One of them has recovered and was discharged. Conclusion The clinical manifestations of NCP in renal transplant recipients were generally consistent with that of ordinary NCP patients. Although there is no established method for the treatment of NCP, it is effective by stopping uses of immunosuppressive agents, maintaining small and medium doses of hormones, actively restoring immunity, and providing respiratory support in a timely manner. Key words: Renal transplant; Novel coronavirus pneumonia (NCP)
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Comparison the Diagnostic Value of Doppler Ultrasonography to Biopsy, in Evaluation of Post-transplant Complications and Kidney Function Overview of global organ donation and transplantation in 2020 Development and prospect of clinical research on lung transplantation in post-COVID-19 era. Risk assessment of organ donation and procurement during COVID-19 epidemic Clinical analysis of 2019 coronavirus disease (COVID-19) on one case with living-related kidney transplantation/ 中华器官移植杂志
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