J Korean Soc Transplant.  2015 Dec;29(4):238-241. 10.4285/jkstn.2015.29.4.238.

Kidney Transplant Patient with a Facial Redness

Affiliations
  • 1Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea. parksk@jbnu.ac.kr
  • 2Department of Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.

Abstract

Posttransplant erythrocytosis (PTE) is a common complication of renal transplantation, which can occur in approximately 10% to 15% of renal transplant patients and usually affects males with relatively good renal function. It is also associated with an increased incidence of thromboembolic events. Clinical manifestations of PTE include malaise, headache, plethora, lethargy, and dizziness. It is correlated with use of cyclosporin, gender, posttransplant renal function, and type of antihypertensive medication. The angiotensin receptor blocker (ARB) or angiotensin-converting enzyme inhibitor is preferred as an initial treatment for PTE because these agents are effective and reasonably safe in the majority of patients with PTE, and can also provide a necessary antihypertensive effect for kidney transplant patients. We report here on a 35-year-old male who had erythrocytosis after renal transplantation. After renal transplantation, his level of hemoglobin was 21 g/dL. We treated this patient with ARB and his symptoms and signs have been completely relieved.

Keyword

Kidney transplantation; Polycythemia; Angiotensin receptor antagonists

MeSH Terms

Adult
Angiotensin Receptor Antagonists
Angiotensins
Cyclosporine
Dizziness
Headache
Humans
Incidence
Kidney Transplantation
Kidney*
Lethargy
Male
Polycythemia
Angiotensin Receptor Antagonists
Angiotensins
Cyclosporine

Figure

  • Fig. 1. This is a picture of patient visiting the transplant center with complaint of a red face.

  • Fig. 2. The finding of a peripheral blood smear shows erythrocytosis (HE stain, ×400).

  • Fig. 3. This graph shows changes in hemoglobin (Hb) and hematocrit (Hct) of this patient after transplantation. The level of Hb and Hct started to decrease after using angiotensin II receptor blocker (ARB), losartan. Abbreviation: PTD, posttransplantation day.


Reference

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