Role of hemodialysis with high cut-off membranes in a patient with a non-recognized leishmaniasis

Gianluca Villa, Maria Grazia D'Alfonso, Paola Di Maggio, Margherita Berardi, Cosimo Chelazzi, Anna Lucia Caldini, A. Raffaele De Gaudio, Gian Franco Gensini, Serafina Valente

Research output: Contribution to journalArticle

Abstract

Background: We report here a case of a woman affected by fever, weight loss, splenomegaly, and leucopenia associated with trombocytopenia, transferred to the intensive care unit with acute kidney injury and septic shock. Methods: Patient was treated with high cut-off continuous veno-venous hemodialysis (HCO-CVVHD). Results: During treatment, the patient experienced a stable improvement in the hemodynamic, pulmonary function and tissue perfusion parameters. After 48 h of treatment, significant reductions in SOFA score (from 12, before starting the procedure, to 6) and in serum inflammatory mediators (as IL-6, from 599-568 pg/ml) were observed. Leishmania infection was identified as responsible of the septic condition only 48 h after removing hemodialysis. Antiprotozoal therapy was begun and the patient discharged. Conclusions: By supporting the renal function and reducing systemic inflammation, HCO-CVVHD could be a useful bridge therapy. This procedure allowed the medical team to gain sufficient time to diagnose the type of infection and begin an etiological therapy.

Original languageEnglish
Pages (from-to)239-241
Number of pages3
JournalBlood Purification
Volume38
Issue number3-4
DOIs
Publication statusPublished - May 22 2014

Keywords

  • Acute kidney injury
  • Blood purification technique
  • High cut-off membrane
  • Leishmaniasis
  • Sepsis

ASJC Scopus subject areas

  • Nephrology
  • Hematology
  • Medicine(all)

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    Villa, G., D'Alfonso, M. G., Di Maggio, P., Berardi, M., Chelazzi, C., Caldini, A. L., De Gaudio, A. R., Gensini, G. F., & Valente, S. (2014). Role of hemodialysis with high cut-off membranes in a patient with a non-recognized leishmaniasis. Blood Purification, 38(3-4), 239-241. https://doi.org/10.1159/000368958