TY - JOUR
TI - Syndrome of Inappropriate Antidiuretic Hormone Secretion Complicating Systemic Nocardiosis in a Renal Transplant Recipient: A Case Report
AU - Melexopoulou, C.
AU - Pavlopoulou, I.D.
AU - Zormpala, A.
AU - Daikos, G.L.
AU - Boletis, J.N.
AU - Marinaki, S.
JO - Transplantation Proceedings
PY - 2017
VL - 49
TODO - 10
SP - 2368-2371
PB - ELSEVIER SCIENCE INC 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN - 0041-1345
TODO - 10.1016/j.transproceed.2017.09.015
TODO - C reactive protein;  cotrimoxazole;  creatinine;  hemoglobin;  imipenem;  methylprednisolone;  mycophenolic acid;  sodium;  tacrolimus;  valganciclovir;  antiinfective agent;  cotrimoxazole;  imipenem;  immunosuppressive agent, acute graft rejection;  aged;  Article;  bacterium identification;  bronchoscopy;  case report;  chemoprophylaxis;  clinical article;  creatinine blood level;  cytomegalovirus infection;  disease duration;  drug blood level;  end stage renal disease;  erythrocyte sedimentation rate;  female;  follow up;  graft recipient;  hemodialysis;  human;  human cell;  immunosuppressive treatment;  inappropriate vasopressin secretion;  kidney graft rejection;  kidney transplantation;  leukocyte count;  lung lavage;  lymphocyte count;  medical history;  neutrophil count;  Nocardia;  nocardiosis;  nonhuman;  oxygen saturation;  Pneumocystis pneumonia;  priority journal;  shoulder discomfort;  shoulder disease;  shoulder pain;  sodium blood level;  systemic nocardiosis;  thorax pain;  thrombocyte count;  treatment duration;  very elderly;  water deprivation;  x-ray computed tomography;  complication;  graft recipient;  immunocompromised patient;  immunology;  inappropriate vasopressin secretion;  microbiology;  nocardiosis, Aged;  Anti-Bacterial Agents;  Female;  Humans;  Imipenem;  Immunocompromised Host;  Immunosuppressive Agents;  Inappropriate ADH Syndrome;  Kidney Transplantation;  Nocardia Infections;  Transplant Recipients;  Trimethoprim, Sulfamethoxazole Drug Combination
TODO - Background Infection by Nocardia species is an uncommon cause of severe clinical syndromes, particularly in immunocompromised patients, and solid-organ transplantation is the most common underlying condition. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) has been described thus far in lung and stem cell transplants with systemic nocardiosis. Case Report We report the first case of SIADH in a female elderly renal transplant recipient diagnosed with systemic nocardiosis 2 years after transplantation. The SIADH was managed appropriately, and her immunosuppressive regimen remained unchanged but was adjusted at a lower level. The systemic Nocardia infection was successfully treated with intravenous administration of trimethoprim-sulfamethoxazole and imipenem for 2 weeks followed by oral trimethoprim-sulfamethoxazole for a total of 12 months. Conclusions The SIADH syndrome is a recognizable complication of Nocardia infection in renal transplant recipients. Prompt identification along with proper management and prolonged antimicrobial treatment are essential to improve patients’ outcome. © 2017 Elsevier Inc.
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