Case 20: Introduction

History of Present Illness (HPI)

clipboardA 37 year-old man with a past medical history of hypertension and end stage kidney disease (ESKD) due to focal segmental glomerulosclerosis (FSGS) who underwent a deceased donor kidney transplant 10 months ago presents to the outpatient transplant clinic for a routine follow up visit. He denies any complaints, though reports he has been a bit more fatigued over the past several weeks.

The patient received anti-thymocyte globulin (ATG) induction therapy and had immediate graft function after transplant. Donor-specific antibodies (DSA) were not present prior to transplantation. He is CMV IgG negative (donor CMV IgG +), EBV IgG positive (donor EBV IgG +). His allograft function has remained stable, with post-transplant nadir creatinine of 1.2 mg/dL. His medications include tacrolimus, mycophenolate mofetil, prednisone, sulfamethoxazole/trimethroprim, amlodipine, and famotidine.

Click here for the physical exam!