Acute myeloma kidney and SARS-COV2 infection with dialysis need: never say never - a case report
Abstract Background Older individuals with multiple comorbidities and especially patients with multiple myeloma are at higher risk of contracting SARS-CoV-2. When patients with multiple myeloma (MM) are also affected by SARS-CoV-2 the time to start immunosuppressants is still a clinical dilemma espe...
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-023-03237-8 |
| _version_ | 1827635247879028736 |
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| author | Gabriele Donati Agnieszka Przygocka Fulvia Zappulo Gisella Vischini Sabrina Valente Gaetano La Manna |
| author_facet | Gabriele Donati Agnieszka Przygocka Fulvia Zappulo Gisella Vischini Sabrina Valente Gaetano La Manna |
| author_sort | Gabriele Donati |
| collection | DOAJ |
| description | Abstract Background Older individuals with multiple comorbidities and especially patients with multiple myeloma are at higher risk of contracting SARS-CoV-2. When patients with multiple myeloma (MM) are also affected by SARS-CoV-2 the time to start immunosuppressants is still a clinical dilemma especially when urgent hemodialysis is required for acute kidney injury (AKI). Case presentation We present a case of an 80-year-old woman who was diagnosed with AKI in MM. The patient began hemodiafiltration (HDF) with free light chain removal combined with bortezomib and dexamethasone. The reduction of free light chains concurrently was obtained by means of HDF using poly ester polymer alloy (PEPA) high-flux filter: 2 PEPA filters were used in series during each 4-h length HDF session. A total of 11 sessions was carried out. The hospitalization was complicated with acute respiratory failure caused by SARS-CoV-2 pneumonia successfully treated with both pharmacotherapy and respiratory support. Once the respiratory status stabilized MM treatment was resumed. The patient was discharged in stable condition after 3 months of hospitalization. The follow up showed significant improvement of the residual renal function which allowed interruption of hemodialysis (HD). Conclusions The complexity of patients affected by MM, AKI, and SARS-CoV-2 should not discourage the attending physicians to offer the adequate treatment. The cooperation of different specialists can lead to a positive outcome in those complicated cases. |
| first_indexed | 2024-03-09T15:25:13Z |
| format | Article |
| id | doaj.art-509917a6830f41008d34313762f05ad3 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-03-09T15:25:13Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-509917a6830f41008d34313762f05ad32023-11-26T12:35:28ZengBMCBMC Nephrology1471-23692023-07-012411710.1186/s12882-023-03237-8Acute myeloma kidney and SARS-COV2 infection with dialysis need: never say never - a case reportGabriele Donati0Agnieszka Przygocka1Fulvia Zappulo2Gisella Vischini3Sabrina Valente4Gaetano La Manna5Nephrology Dialysis and Renal Transplantation Unit, Azienda Ospedaliero-Universitaria di Modena. Surgical, Medical, Dental and Morphological Sciences Department (CHIMOMO), University of Modena and Reggio EmiliaNephrology Dialysis and Renal Transplantation Unit, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, IRCCS Azienda Ospedaliero Universitaria di BolognaNephrology Dialysis and Renal Transplantation Unit, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, IRCCS Azienda Ospedaliero Universitaria di BolognaNephrology Dialysis and Renal Transplantation Unit, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, IRCCS Azienda Ospedaliero Universitaria di BolognaClinical Pathology, Department of Experimental, Diagnostic and Speciality Medicine (DIMES), University of BolognaNephrology Dialysis and Renal Transplantation Unit, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, IRCCS Azienda Ospedaliero Universitaria di BolognaAbstract Background Older individuals with multiple comorbidities and especially patients with multiple myeloma are at higher risk of contracting SARS-CoV-2. When patients with multiple myeloma (MM) are also affected by SARS-CoV-2 the time to start immunosuppressants is still a clinical dilemma especially when urgent hemodialysis is required for acute kidney injury (AKI). Case presentation We present a case of an 80-year-old woman who was diagnosed with AKI in MM. The patient began hemodiafiltration (HDF) with free light chain removal combined with bortezomib and dexamethasone. The reduction of free light chains concurrently was obtained by means of HDF using poly ester polymer alloy (PEPA) high-flux filter: 2 PEPA filters were used in series during each 4-h length HDF session. A total of 11 sessions was carried out. The hospitalization was complicated with acute respiratory failure caused by SARS-CoV-2 pneumonia successfully treated with both pharmacotherapy and respiratory support. Once the respiratory status stabilized MM treatment was resumed. The patient was discharged in stable condition after 3 months of hospitalization. The follow up showed significant improvement of the residual renal function which allowed interruption of hemodialysis (HD). Conclusions The complexity of patients affected by MM, AKI, and SARS-CoV-2 should not discourage the attending physicians to offer the adequate treatment. The cooperation of different specialists can lead to a positive outcome in those complicated cases.https://doi.org/10.1186/s12882-023-03237-8AKISars-CoV-2Multiple myelomaDialysisCase report |
| spellingShingle | Gabriele Donati Agnieszka Przygocka Fulvia Zappulo Gisella Vischini Sabrina Valente Gaetano La Manna Acute myeloma kidney and SARS-COV2 infection with dialysis need: never say never - a case report BMC Nephrology AKI Sars-CoV-2 Multiple myeloma Dialysis Case report |
| title | Acute myeloma kidney and SARS-COV2 infection with dialysis need: never say never - a case report |
| title_full | Acute myeloma kidney and SARS-COV2 infection with dialysis need: never say never - a case report |
| title_fullStr | Acute myeloma kidney and SARS-COV2 infection with dialysis need: never say never - a case report |
| title_full_unstemmed | Acute myeloma kidney and SARS-COV2 infection with dialysis need: never say never - a case report |
| title_short | Acute myeloma kidney and SARS-COV2 infection with dialysis need: never say never - a case report |
| title_sort | acute myeloma kidney and sars cov2 infection with dialysis need never say never a case report |
| topic | AKI Sars-CoV-2 Multiple myeloma Dialysis Case report |
| url | https://doi.org/10.1186/s12882-023-03237-8 |
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