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P8.027 Idiopathic polymyositis in renal transplant recipient: case report and review of literature

Osama Ashry Gheith, Egypt

Mansoura university

Biography

Biography

I am Dr. Osama Ashry Ahmed Gheith, who graduated in 1987 from Mansoura faculty of medicine, Egypt. I have held an MD degree in Internal Medicine and Nephrology since 2003. I have been trained at Mansoura urology and nephrology center, Mansoura University, Egypt from 1991 till 2008 when I join the work at Hamed Al-Essa organ transplant center.

I am a member of the following societies: International Society of Nephrology (ISN), European Dialysis Transplantation Association (EDTA), African Association of Nephrology (AFRAN), Arab Society of Nephrology, and Egyptian Society of Nephrology (ESN).

I have long experience with all nephrology activities including all dialysis modalities, medical care of more than 3500 renal transplant recipients, and surgical Skills of importance in the field of nephrology as vascular access creation, PD catheter insertion, and renal biopsies. Moreover, I am interested in training and supervising Junior Staff in nephrology and renal transplant (in Egypt, Yemen, and Kuwait).

I have completed the NIH Web-based training course “Protecting Human Research Participants”. I am interested in research work and have over 12 research projects ongoing in the department. I am an author and/or co-author of over 85 publications in peer-reviewed international journals. In addition to several abstracts in many Middle East and international conferences. I am interested in the field of immunosuppression in renal transplantation, post-transplant diabetes, infection, and anemia.

I won some of the research prizes with the special concern of Emirates medical association –Nephrology Society EMAN YOUNG INVESTIGATOR AWARD –during the 12th congress of the Arab society of nephrology and renal transplantation 2014, 6th ISN EMAN Update Course in Nephrology 2014, 10-13December 2014 Dubai, UAE; one of the top 5 posters presented in ESNT 2018 (impact of HLA DR mismatch in elderly renal transplant recipients regardless donor sources: single-center experience from the middle east) and one of the top 5 posters presented in ESNT 2019 (Screening for BK viremia/viruria and the Impact of Management of BK Virus Nephropathy in Renal Transplant Recipients).

Abstract

Idiopathic polymyositis in renal transplant recipient: case report and review of literature

Ahmed Yehia1, Osama Gheith1,2, Mohamed Abdel Menem1, Medhat Alawady1, Prasad Nair1, Eslam Sobhy1, Ayman Maher1,2, Khalid Abdultawab1, Ahmad Abbas 1, Torki Alotaibi1.

1Nephrology , Otc, Kuwait, Kuwait; 2Nephrology , MUNC, Mansoura, Egypt

Introduction and aim: Myositis is a rare complication following renal transplant and is most commonly the result of a drug-mediated myotoxicity, but the idiopathic cause is still the most common.

After kidney transplant, the differential diagnosis of polymyositis includes autoimmune disease, drug-induced viral infections, and rhabdomyolysis associated with electrolyte imbalance. We aimed to report a case of idiopathic polymyositis in a renal transplant recipient and review the literature for similar cases.

Case report: A 31-year-old male patient developed polymyositis three years following live-related kidney transplantation. Electromyography confirmed myopathic changes. The clinical features and course, MRI findings, EMG features, positive anti-MI-2 antibody, and the response to high-dose steroid therapy are matched with immune-mediated acute polymyositis, especially after excluding viral infections and drug-induced myopathy.

Conclusion: Acute polymyositis may occur after a kidney transplant. Possible mechanisms include viral antigen transmission or a localized graft vs. host disease. Muscle biopsy is not mandatory before prompt initiation of high-dose steroid therapy, which leads to clinical and biochemical recovery.

Keywords: Polymyositis, kidney transplant, outcome

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