Abstract | INTRODUCTION: CASE REPORT: A 64-year-old female liver transplant recipient was begun on treatment of fibrosis cholestatic hepatitis with pegylated-interferon-α2a and ribavirin therapy. She received a one-time dose of pegylated-interferon-α2a 135 mcg subcutaneously, and ribavirin was initiated. Within 24 hours of treatment initiation, she developed an acute kidney injury with serum creatinine increased from a baseline 132.6 μmol/L (1.5 mg/dL) to 459.7 μmol/L (5.2 mg/dL) within 72 hours. Ultrasound and computed tomography of the kidneys were normal with no stones and urinalysis showed no crystals. Her ribavirin dosage was adjusted based on her changing renal function. Within 72 hours after treatment initiation, her serum uric acid level was 1392 μmol/L (23.4 mg/dL), for which she received rasburicase 3 mg intravenously. Ribavirin was discontinued at this time. The next day, her serum uric acid level and remained elevated at 1166 μmol/L (19.6 mg/dL) and she received a second dose of rasburicase 7.5 mg and hemodialysis. Her serum uric acid level decreased to 131 μmol/L (2.2 mg/dL) and remained within normal limits; however, she continued to require intermittent hemodialysis until she died from complications of sepsis 38 days after admission. After discontinuation, she was not rechallenged with pegylated-interferon-α2a /and ribavirin. CONCLUSIONS:
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Authors | John P Knorr, Daranee Chewaproug, Surekha Neeli, Elio Torres, Radi Zaki |
Journal | Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
(Exp Clin Transplant)
Vol. 13
Issue 6
Pg. 596-9
(Dec 2015)
ISSN: 2146-8427 [Electronic] Turkey |
PMID | 25806515
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Gout Suppressants
- Interferon alpha-2
- Interferon-alpha
- Recombinant Proteins
- rasburicase
- Ribavirin
- Urate Oxidase
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Topics |
- Female
- Gout Suppressants
(therapeutic use)
- Humans
- Hyperuricemia
(chemically induced)
- Interferon alpha-2
- Interferon-alpha
(administration & dosage, adverse effects)
- Liver Transplantation
- Middle Aged
- Postoperative Complications
(chemically induced)
- Recombinant Proteins
(administration & dosage, adverse effects)
- Ribavirin
(administration & dosage, adverse effects)
- Urate Oxidase
(therapeutic use)
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