Acute Myocardial Infarction due to Sepsis in a Renal Allograft Recipient.
- Author:
Il Hyun BACK
1
;
Tae Won LEE
;
Sung Pyo HONG
;
Chun Kyu LIM
;
Myung Jae KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Myocardial infarction;
DIC;
Renal transplantation
- MeSH:
Adrenal Cortex Hormones;
Adult;
Allografts*;
Cefuroxime;
Dacarbazine;
Dalteparin;
Diagnosis;
Diarrhea;
Electrocardiography;
Female;
Fever;
Follow-Up Studies;
Humans;
Hypotension;
Incidence;
Kidney;
Kidney Transplantation;
Myocardial Infarction*;
Physical Examination;
Sepsis*;
Shock;
Shock, Septic;
Sputum;
Thromboembolism;
Troponin I
- From:Korean Journal of Nephrology
1999;18(5):830-835
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Despite improvements in surgical technique, immunosuppressive therapy, and follow-up care, a considerable number of patients with kidney transplants die as a consequence of sepsis and throm-boembolism. The incidence of thromboembolism is higher in patients older than 40 years of age. Prominent among these is an increased incidence of acute myocardial infarction(AMI) in patients receiving corticosteroids. We encountered a rare case that septic shock due to artificial abortion, ARF, and DIC complicated by AMI. A 25-year-old female complained of fever, and watery diarrhea. She was emmergently admitted due to shock. Physical examination demonstrated hypotension and fever. WBC count was 45,300/mL. Elevated FDP, D dimer, CK with dominance of the MB isoenzyme, and troponin-I. EKG showed ST segment elevation in leads aVF, V3-V6. She was treated with cefuroxime, netilmycin, and dalteparin. Cultures obtained from the sputum, urine, and blood did not yield any microorganisms. Although sepsis could not be confirmed, sepsis was highly suspected from the clinical features. This is a rare case in which septic shock, ARF, and DIC complicated by AMI in a young female renal allograft patient. Since AMI in the absence of underlying conditions has been rarely described, we wish to bring attention to the diagnosis of this disorder in a young female allograft recipient and without any other predisposing abnormality.
