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신이식 환자에서 인공유산 후 패혈증으로 인한 급성 심근경색증 (Acute Myocardial Infarction due to Sepsis in a Renal Allograft Recipient) |
백일현(Il Hyun Back),이태원(Tae Won Lee),홍성표(Sung Pyo Hong),임천규(Chun Kyu Lim),김명재(Myung Jae Kim) |
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Abstract |
Despite improvements in surgical technique, immunosuppressive therapy, and follow-up care, a considerable number of patients with kidney transplants die as a consequence of sepsis and throm-boembolism. The incidence of thromboembolism is higher in patients older than 40 years of age. Prominent among these is an increased incidence of acute myocardial infarction(AMI) in patients receiving corticosteroids. We encountered a rare case that septic shock due to artificial abortion, ARF, and DIC complicated by AMI. A 25-year-old female complained of fever, and watery diarrhea. She was emmergently admitted due to shock. Physical examination demonstrated hypotension and fever. WBC count was 45,300/mL. Elevated FDP, D dimer, CK with dominance of the MB isoenzyme, and troponin-I. EKG showed ST segment elevation in leads aVF, V3-V6. She was treated with cefuroxime, netilmycin, and dalteparin. Cultures obtained from the sputum, urine, and blood did not yield any microorganisms. Although sepsis could not be confirmed, sepsis was highly suspected from the clinical features. This is a rare case in which septic shock, ARF, and DIC complicated by AMI in a young female renal allograft patient. Since AMI in the absence of underlying conditions has been rarely described, we wish to bring attention to the diagnosis of this disorder in a young female allograft recipient and without any other predisposing abnormality. |
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