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        "titulo" => "Enfermedad tardía por citomegalovirus en el trasplante renal: dos casos clínicos"
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      "titulo" => "Rhabdomyolysis due to hypothermia in immigrant illegal patient who arrives in small boat"
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    "cita" => "Nefrologia (English Version). 2007;27:389-90"
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      "titulo" => "HIPOKALIEMIA SINTOMÁTICA ASOCIADA A ENFERMEDAD DE CACCHI-RICCI"
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    "titulo" => "Late-onset cytomegalovirus disease following renal transplantation: A report of two cases."
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        "autoresLista" => "Silvia Soto Alarcón, Concepción Alcazar, Luisa Jimeno, Maria Jose Gonzalez Soriano, Servicio de Nefrología del Hospital Universitario Virg"
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        "resumen" => "II) Summary Cytomegalovirus is the most frequent infection in patients undergoing renal transplantation&#59; typically occurs 1 to 4 months after transplantation. It could came up after the third month, usually due to the use of antiviral prophylaxis in high risk patients, anyhow is infrequent after the first year of the transplantation, and the reactivate mechanisms are not clear. We herein report three cases that were diagnosed to CMV disease 13 years, 6 years and 8 years after transplantation. The first one, a 43-year-old woman with a history of pyrosis and epigastralgia 13 years after transplantation. Endoscopically, gastric ulcer was identified. In the histological examination, cytomegalic inclusion bodies were found. She recovers completely after treatment with oral ganciclovir. The second one, a 70-year-old man, transplanted 6 years before. He showed, in the context of E. Coli bacteraemia, CMV disease with positive antigenemia and acute renal failure, requiring haemodialysis. The third case is a 55-year-old woman, who presented allograft dysfunction 8 years after transplantation. A renal biopsy was made and it showed interstitial nephritis with C4d deposits along peritubular capillaries. She was treated with metil-prednisolona bolus, plasmapheresis and Tacrolimus rescue without improvement of renal function and requiring haemodialysis. Few days later she had fever and thrombocytopenia, with CMV antigenemia positive. Valganciclovir were started with improvement of her sintomathology. These three cases prove that CMV disease is not only linked to the first transplantation stages, requiring considering it in further stages, although the way it shows and the risk factors are still to be known. "
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