Efficacy and Safety of Mycophenolate Mofetil In De Novo Renal Transplantation in a Retrospective Cohort of Transplant Recipients in Colombia-Esmitren Study

BACKGROUND

To describe and establish the efficacy and safety of Mycophenolate Mofetil (Micoflavin) in patients with de novo renal transplantation during one-year post-transplant follow-up. As secondary objectives, the behavior of mycophenolic acid (MPA) C0 levels in this population, the relationship between MPA levels and renal function of the grafts, the incidence of acute rejection, and the incidence of adverse effects were evaluated.

METHODS

A prospective cohort study was conducted on patients who received a first kidney transplant from a deceased donor between March 1, 2021, and February 28, 2022, at the Alma Mater of Antioquia Hospital of the Antioquia's University, in Medellín, Colombia. MPA C0 levels were taken from the patients on days 15, 30, 90, 180, and 360 after the kidney transplantation.

RESULTS

Patients presented MPA therapeutic levels in the study. The average of the MPA levels in the population was 2.5 µg/mL, with an IQR of 2.13 to 3.32. There were 5 acute rejections (27%), but none of the patients with acute rejection presented subtherapeutic levels of mycophenolate. No significant relationship was observed between mycophenolic acid levels and rejection (P = .255). The patients who completed the study had no gastrointestinal intolerance to mycophenolate, cytomegalovirus infections, or significant hematological complications.

CONCLUSIONS

MMF (Micoflavin) maintained mycophenolic acid levels C0 within the therapeutic range, was well tolerated and without the presence of significant adverse events, and maintained stable renal function throughout the follow-up period in the population studied.

Enfermedad de Fabry: un año en tratamiento con migalastat

Introducción: la enfermedad de Fabry (o enfermedad de Anderson-Fabry) es una enfermedad de depósito lisosomal causada por la deficiencia o ausencia de la enzima ?-galactosidasa A, responsable del catabolismo del glicoesfingolípido globotriaosilceramida (Gb3). Objetivo: en este artículo se expone el caso de un paciente que, a la edad de 64 años con diagnóstico de enfermedad de Fabry, comienza tratamiento con la nueva chaperona oral (migalastat), con evidencia de mejoría en su historia natural de la enfermedad. Presentación del caso: paciente masculino de 64 años de edad, oriundo de Porto, Portugal, residente en Medellín, Colombia, con enfermedad de Fabry diagnosticada en el año 2010, que fue causada debido a la actividad de la Alfa Galactosidasa A más la mutación fenotípica C.239G>A. Discusión y conclusión: este reporte de caso ha demostrado la adecuada respuesta del paciente en el manejo con la chaperona farmacológica migalastat. Por lo tanto, un paciente con enfermedad de Fabry, con manifestaciones típicas y una mutación GLA confirmada y que es susceptible de recibir migalastat, tiene esta excelente opción terapéutica con resultados favorables para sus signos y síntomas. Migalastat (chaperón farmacológico) es un tratamiento oral eficaz y seguro que se traduce en comodidad y beneficios para el paciente y su entorno, lo que permite una mejora significativa de la calidad de vida del paciente.

Disseminated Streptococcus bovis infection after consumption of manatee meat: A case report and review of the literature

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Disseminated S. bovis group infections are unusual in adults.

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S. bovis infections are usually related to colorectal neoplasia o biliary tract disease.

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S. bovis group zoonotic transmission could be biologically plausible, as infection in marine animals has been documented.

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No cases of S. bovis group have been published in relation to manatee ingestion.

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Wild animal consumption increases the risk of serious infections that could represent a hazard for public health.

Streptococcus bovis bacteremia (currently called S. gallolyticus) represents an infrequent condition, but associated with a high rate of morbidity and mortality Amado et al. (2015). The clinical presentation is characterized by symptoms associated with disseminated infection and with a higher frequency of endocarditis and gastrointestinal neoplasms, often occult Amado et al. (2015), Olmos et al. (2016). Probable sources of infection and zoonotic transmission have not been explored in the literature. We present a case of disseminated infection after ingestion of a marine mammal.