Mehmet Emirhan IŞIK, Deniz GÜNAY, mehmet aksüt, Şirin MENEKŞE, Yeşim UYGUN KIZMAZ, MEHMET KAAN KIRALİ

COVID-19 presenting with diarrhea in a heart transplant patient

A 55-year-old man who underwent bicaval orthotopic heart transplantation nine months earlier presented with complaints of diarrhea and oliguria. Laboratory findings showed pancytopenia and an elevated creatinine level. Cyclosporine and mycophenolate mofetil were discontinued, and the patient received only everolimus. As he was immunosuppressed and had atypical symptoms during the COVID-19 pandemic, reverse transcriptase-polymerase chain reaction testing was performed, which yielded a positive result. Treatment with hydroxychloroquine and favipiravir were initiated. Although the patient suffered from acute renal failure, his condition showed an improvement after hydration plus a five-day antiviral treatment and, then, treatment was stopped. His COVID-19 test was negative after 10 days of follow-up and treatment, and he was discharged with cyclosporin and mycophenolate mofetil.

Kalp nakilli bir hastada ishal ile seyreden COVID-19

Dokuz ay önce bikaval ortotopik kalp nakli yapılan 55 yaşında erkek hasta, ishal ve oligüri şikayetleri ile başvurdu. Laboratuvar bulgularında pansitopeni ve kreatinin düzeylerinde artış izlendi. Siklosporin ve mikofenolat mofetil sonlandırıldı ve hastaya sadece everolimus verildi. COVID-19 pandemisinde hastanın bağışıklık sistemi baskılanmış ve atipik semptomları olduğu için, revers transkriptaz polimeraz zincir reaksiyonu testi yapıldı ve sonuç pozitif saptandı. Hidroksiklorokin ve favipiravir tedavisi başlandı. Akut böbrek yetmezliği de olan hastanın durumunda hidrasyon ve beş günlük antiviral tedavi sonrasında iyileşme görüldü ve tedavi sonlandırıldı. On günlük takip ve tedavi sonrasında COVID-19 testi negatif olan hasta, siklosporin ve mikofenolat mofetil ile taburcu edildi.

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