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Brachial artery aneurysm and unspecified recurrent infections: case report A male patient [age not stated] developed brachial artery aneurysm and unspecified recurrent infections during immunosuppressive treatment with ciclosporin, mycophenolic acid and prednisolone [duration of treatments to reaction onsets not stated]. The patient, who was diagnosed with end-stage kidney disease due to chronic glomerulonephritis in 1991, was placed on dialysis for 4 years and then underwent two renal transplantations in 1993 and 1996, respectively. He also had multiple comorbidities and was diagnosed with chronic transplant dysfunction of the kidney. His current immunosuppressive treatment comprised of ciclosporin, mycophenolic acid and prednisolone [dosages and routes not stated]. Thereafter, he presented to the hospital with a large, erythematous, oval tumour on his right upper arm at a former arteriovenous (AV) fistula site. Additionally, he experienced sensory loss in his right forearm which could represent oedema in his right hand and damage to the antebrachial cutaneous nerve. He reported that he had noticed development of the tumour 8 years prior but observed rapid growth for 2 months before his current admission for worsening renal function. An MRI scan, Doppler ultrasound and X-ray could not explain the nature of the tumour. Finally, his tumour was resected, which showed the development of a large brachial artery aneurysm. Post aneurysmatic brachial artery resection, the basilic vein was used to re-establish continuity. The pathological study revealed an aneurysmatic vessel with older bleeding, sclerotic changes, obliterative thrombosis, and clusters of inflammation as seen in a foreign body reaction without evidence for malignancy or vasculitis. Based on his history, presenting symptoms and findings, he was diagnosed with immunosuppressive treatment-related brachial artery aneurysm. On postoperative day 3, due to the increase in inflammatory markers, he was started on empiric antibacterial treatment with meropenem and followed-up for about 1 year. Thereafter, he developed unspecified recurrent infectious secondary to immunosuppressive treatment with ciclosporin, mycophenolic acid and prednisolone. Eventually, he died due to the recurrent infectious complications and chronic heart failure. Schilling EM, et al. Giant brachial artery aneurysm as a rare complication of a dialysis shunt. Journal of Vascular Access 21: 799-802, No. 5, Sep 2020. Available from: URL: 803505084 http://doi.org/10.1177/1129729819886746

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