Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Antagonistas del Receptor de Bradiquinina B2/uso terapéutico , Bradiquinina/análogos & derivados , Tratamiento Farmacológico de COVID-19 , Bradiquinina/uso terapéutico , COVID-19/diagnóstico , COVID-19/fisiopatología , Humanos , Pulmón/efectos de los fármacos , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , SARS-CoV-2 , Resultado del TratamientoRESUMEN
Gitelman's syndrome is a rare autosomal-recessive tubular disorder characterized by hypomagnesemia and hypocalciuria associated to hypokalemia. The clinical spectrum is wide and usually characterized by chronic fatigue, cramps, muscle weakness and paresthesiae. We describe a case of a 43 year-old male patient with early onset of knee arthritis and no other symptoms. Ultrasound revealed diffuse and confluent hyperechoic deposits in cartilage, fibrocartilage of the menisci and synovium and calcium pyrophosphate crystals were observed in the synovial fluid of the knee. The concomitant presence of hypomagnesemia, hypocalciuria and hypokalemia made clear the diagnosis of Gitelman's syndrome associated with chondrocalcinosis.
Asunto(s)
Condrocalcinosis/diagnóstico , Condrocalcinosis/etiología , Síndrome de Gitelman/complicaciones , Síndrome de Gitelman/diagnóstico , Ultrasonografía , Adulto , Biomarcadores/sangre , Calcio/sangre , Calcio/orina , Condrocalcinosis/sangre , Diagnóstico Diferencial , Diagnóstico Precoz , Síndrome de Gitelman/sangre , Síndrome de Gitelman/genética , Humanos , Hipopotasemia/sangre , Magnesio/sangre , Masculino , Mutación , Medición de Riesgo , Índice de Severidad de la Enfermedad , Miembro 3 de la Familia de Transportadores de Soluto 12/sangreRESUMEN
Since the introduction of combined antiretroviral therapy, human immunodeficiency virus (HIV) infection is no longer a contraindication for solid organ transplantation. In HIV/hepatitis C virus (HCV)-coinfected patients undergoing liver transplantation, HCV-related cirrhosis, drug-drug interactions, and calcineurin inhibitors-related toxicity affect clinical outcomes. Therapeutic drug monitoring can be useful to assess antiretroviral over- or underexposure in this cohort. We report the clinical characteristics along with antiretroviral trough levels of maraviroc, darunavir, and etravirine in 3 HIV/HCV-coinfected liver transplant recipients who developed post-transplant liver cirrhosis.