Case 40: Introduction

History of Present Illness (HPI)

clipboardA 40 year-old woman with a past medical history hypertension and end stage kidney disease (ESKD) due to human immunodeficiency virus (HIV) nephropathy who underwent a deceased donor kidney transplant 5 months ago presents to the outpatient transplant clinic for a routine follow up visit.

The patient received basiliximab induction therapy and had immediate graft function after transplant. Donor-specific antibodies (DSA) were not present prior to transplantation. She is CMV IgG positive (donor CMV IgG -), EBV IgG positive (donor EBV IgG +). Her post-transplant nadir creatinine was 1.2 mg/dL and found to be 1.95 mg/dL today. Her medications include tacrolimus 2 mg twice daily, mycophenolate mofetil 1000 mg twice daily, prednisone 5 mg, sulfamethoxazole/trimethroprim 1 tablet daily, amlodipine 10 mg, and famotidine 20 mg.

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