Abstract: FR-PO786
Phlegmonous Gastritis After Renal Transplantation First Case Reported in the Literature
Session Information
- Post-Transplantation and Case Reports
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Montaño, Alejandro Rojas, Hospital Angeles del Pedregal, Mexico City, Mexico City, Mexico
- Corona-Deschamps, Axel, Hospital Angeles del Pedregal, Mexico City, Mexico City, Mexico
- Salgado-Ambrosio, Lucero, Hospital Angeles del Pedregal, Mexico City, Mexico City, Mexico
- Nieves Perez, Cesar Adolfo, Hospital Angeles del Pedregal, Mexico City, Mexico City, Mexico
Group or Team Name
- Equipo Nefrología-Trasplante Ángeles Pedregal.
Introduction
Phlegmonous gastritis (PG) is a rare condition.Approximately one case per year has been reported in the literature, with a total of around 500 reported cases. We present the first case of phlegmonous gastritis following kidney transplantation, to the best of our knowledge based on the literature available.
Case Description
This is about a 36-year-old man with a history of type 2 diabetes, systemic arterial hypertension, chronic kidney disease, who underwent a living-related kidney transplant in 2022, with a PRA-SA of 0/0%. He received induction with basiliximab and methylprednisolone, and maintenance immunosuppression with tacrolimus, mycophenolic acid, and prednisone. With baseline creatinine of 1.0 mg/dL. Two months after the transplant, he developed ,fever, oral intolerance. He was hospitalized, and a fever of 40 °C was documented, mild epigastric tenderness was noted on abdominal examination. Laboratory tests revealed leukocytosis, elevated C-reactive protein, creatinine (2.5 mg/dL). Abdominal computed tomography confirmed pneumobilia, pneumoperitoneum, gastric wall thickening. Tacrolimus and mycophenolic acid were discontinued, and steroid therapy was continued. Meropenem was initiated. An endoscopy performed within 12 hours of symptom onset revealed multiple areas of diffuse gastric necrosis and purulent material. Linezolid was added to the treatment regimen, and a nasojejunal tube was placed for total enteral nutrition. Pseudomonas aeruginosa putida and Candida glabrata were isolated from the gastric tissue. He was discharged on day 27 with a baseline creatinine level of 0.9 mg/dL, and on cyclosporine and prednisone.
Discussion
PG is a condition with high mortality. It is important to suspect it in immunosuppressed patients with sepsis, as early diagnosis can save the patient's life and prevent serious complications.