Multiple hepatic nodules in a renal transplant recipient.
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 Cyclosporine and sirolimus were tapered and corticosteroid withdrawn gradually.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.
Shu
K-H
KH
Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. khshu@vghtc.gov.tw
Chai
J-W
JW
D001706:Biopsy; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006084:Graft Rejection / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D007166:Immunosuppressive Agents