1. Multiple hepatic nodules in a renal transplant recipient
- Author
-
Chai Jw and Shu Kh
- Subjects
Graft Rejection ,medicine.medical_specialty ,medicine.drug_class ,Biopsy ,Malignancy ,Gastroenterology ,Diagnosis, Differential ,chemistry.chemical_compound ,Internal medicine ,medicine ,Humans ,Kidney transplantation ,Creatinine ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Surgery ,Fatty Liver ,Transplantation ,chemistry ,Nephrology ,Sirolimus ,Prednisolone ,Kidney Failure, Chronic ,Corticosteroid ,Female ,Liver function ,Tomography, X-Ray Computed ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
A 55-year-old female received a cadaveric renal transplant in 2003. Sixteen months later, multiple liver nodules were found in a routine abdominal sonogram follow-up. Serial studies were all negative for malignancy. She was placed on a quadruple immunosuppressive regimen, including prednisolone, cyclosporine, mycophenolate mofetil and sirolimus. Her graft function was stable with serum creatinine of 1.0 mg/dl and there had been no rejection since transplantation. Liver function and lipid profile were within normal limits. Serum ferritin level was 1,466 ng/ml. Two liver biopsies, 4 months apart, showed fatty metamorphosis of the liver and no tumor. She was closely watched and no malignancy was found in the subsequent 3 years. Cyclosporine and sirolimus were tapered and corticosteroid withdrawn gradually. Serum ferritin level gradually declined to 600 - 800 ng/ml in subsequent years. Interestingly, the liver nodules gradually disappeared and there were only a few left on the last follow-up in April, 2008.
- Published
- 2009