<span class="Apple-style-span" style="color:rgb(51,51,51);font-family:arial,sans-serif;font-size:16px"><span class="hps">Dear</span> <span class="hps">colleagues</span><span>, I have a</span> <span class="hps">liver</span> <span class="hps">transplant patient</span> <span class="hps">for 5</span> <span class="hps">months in</span> <span class="hps">use of</span> <span class="hps">FK</span> <span class="hps">and MMF</span> <span class="hps">with a</span> rapid progressive <span class="hps">tegumentar</span> <span class="hps">leishmaniasis</span> <span class="hps">in the face</span><span>.</span> <span class="hps">does anyone have any</span><span class="hps">experience in treating</span> <span class="hps">this scenario.</span> <span class="hps">Furthermore</span><span>, the patient has</span> <span class="hps">diabetes and hypertension</span> and <span class="hps">is</span> <span class="hps">admitted to</span> the hospital because of <span class="hps">intense </span><span class="hps">asthenia</span> <span class="hps">and</span> <span class="hps">peripheral neuropathy</span><span>.</span> Also s<span class="hps">hows marked</span> <span class="hps">elevation of</span> <span class="hps">liver enzymes wich is</span> <span class="hps">under </span><span class="hps">investigation</span><span>.</span> a liver biopsy is planned. <span class="hps">The main</span> <span class="hps">hypotheses are</span> <span class="hps">FK</span> <span class="hps">toxicity</span> <span class="hps">and/or</span> post transplant <span class="hps">recurrence</span> <span class="hps">of HCV</span><span>. </span><span class="hps">(rejection</span> <span class="hps">seems less likely</span> <span class="hps">because the</span> <span class="hps">serum level</span> <span class="hps">was pretty</span> <span class="hps">high).</span></span><div>
<span class="Apple-style-span" style="color:rgb(51,51,51);font-family:arial,sans-serif;font-size:16px"><span class="hps">thanks everybody.</span></span></div><div><span class="Apple-style-span" style="color:rgb(51,51,51);font-family:arial,sans-serif;font-size:16px"><span class="hps">hugs</span></span></div>
<div><span class="Apple-style-span" style="color:rgb(51,51,51);font-family:arial,sans-serif;font-size:16px"><span class="hps">Thor Dantas</span></span></div>