10 year review of invasive aspergillosis detected at necropsy

Article Abstract:

Aspergillosis is caused by an infection with a fungus called aspergillus, and most commonly affects the lungs. Aspergillosis most frequently occurs in patients with diseases that suppress the immune system, such as AIDS, and patients who are being treated with drugs that suppress the immune system, as the organ transplant recipients and cancer chemotherapy patients. It is expected that the number of cases of aspergillosis will continue to increase as the number of organ transplants increases and as the use of toxic drugs to treat malignant diseases increases. To determine the incidence of aspergillosis and to identify patients with the greatest risk of developing aspergillosis, the medical records obtained from 2,315 autopsies, performed between 1980 and 1989, were reviewed. There were 299 patients classified as 'high risk' for developing aspergillosis. Of these patients, 71 had liver transplants, 41 had kidney transplants, 33 underwent chemotherapy for solid cancerous tumors, and 154 had a malignant blood disease (some of these patients also received chemotherapy). There were 32 cases of aspergillosis identified. Of the patients with aspergillosis, 12 had liver transplants, 16 had blood diseases, and 1 had a kidney transplant. These results indicate that patients undergoing liver transplants and patients with malignant blood disorders are at greater risk for developing aspergillosis than patients undergoing kidney transplants or chemotherapy treatment for solid tumors. Also, the liver transplant patients were at greater risk for having the infection spread to other parts of the body. This increased risk was related to the use of high doses of steroids to prevent rejection of the transplanted organ. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Risk factors, Statistics, Autopsy, Immunosuppressive agents, Aspergillosis, Lung diseases, Fungal, Fungal lung diseases

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Central pontine myelinolysis in liver transplantation

Article Abstract:

The loss of myelin, the substance that forms an insulating sheath around axons, from the pontine basalis in the brain occurs in the syndrome known as central pontine myelinolysis (CPM). CPM can occur in patients with severe liver disease and those who undergo liver transplantation. The neurological manifestations of this disorder can be minor or severe, including the loss of functioning of all extremities and a type of palsy. The cause of CPM is not certain, but a rapid increase in the concentration of sodium in the body may be involved. This hypothesis was tested in patients who had undergone liver transplantation and whose levels of sodium were carefully monitored. Out of 50 liver transplantation patients, five (10 percent) developed CPM. In all cases, the condition was only detected at autopsy. Two of these five patients (40 percent) underwent a rapid increase in sodium, but changes in sodium levels did not appear to be directly associated with the development of CPM. CPM can occur even if rapid changes of sodium do not occur. Nevertheless, major changes in the concentrations of sodium in liver transplantation patients should be avoided. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Liver diseases, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Demyelinating diseases, Sodium in the body, Sodium (Nutrient)

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