Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: ciprofloxacin / dilantin / amoxicillin / lorazepam / gadolinium-containing agents attending: chief complaint: hematemesis and hypotension major surgical or invasive procedure: egd: no active bleed but visible vessel at ge junction. 3 clips placed, epi injected. no residual bleeding history of present illness: cc:. hpi: mr. is a 68 year old man with a history of alport syndrome on hemodialysis now presenting with several hours of hematemesis. he awoke this morning feeling well and then had a sudden onset of malaise and lightheadedness around 8am. shortly thereafter, he felt nauseous and began vomitting frank red , he called ems. he reportedly vomitted an additional 500 cc of while int he ambulance, though ems and ed records are not currently available for review. . in the ed, he was initially hypotensive to 81/41 and tachycardic (records from the ed are not currently available for review). he completed a 1000cc ns bolus that was started by ems. he received pantoprazole 40 mg iv and three units of uncrossed prbcs. his bp was reportedly 78/45 prior to transfer with hr 108, though he did not have any lightheadedness or further bloody emesis. . he denies any nsaid or alcohol use (he does take a baby aspirin daily). of note, he has been having "stomachaches" and intermittent "dry heaves" over the past month since starting imatinib off-label for nephrogenic systemic fibrosis. due to these symptoms, he self-reduced the dose down to 200 mg daily about 5-6 days ago. . review of systems: denies any headaches, visual changes, leg edema, chest/abdominal pain, dyspnea. past medical history: . past medical history: - alport syndrome with bilateral hearing loss - ckd v on hd for over 40 yrs; left av fistula; started off-label imatinib on for nephrogenic systemic fibrosis - one prior episode of hematemesis in when uremic after a failed renal transplant - s/p l-spine fusion - s/p ccy - ? amyloidosis - grand mal seizure during hemodialysis in - spontaneous retroperitoneal/iliopsoas bleed in - history of c2 vertebral body instability in ; cause unclear - colonic polyps by report in - s/p right hip arthroplasty - s/p bilateral carpal tunnel surgeries - mild aortic stenosis (per pt) on tte at in - mild mitral stenosis (per pt) - secondary hyperparathyroidism s/p 3.5 gland parathyroidectomy in social history: lives with wife. professor of mathematics. does not smoke or drink alcohol. family history: nc physical exam: . physical examination: t 97.3 (axillary) bp 154/73 hr 104 rr 16 sat 100% on 2 l/min nc weight: 65.3 kg (bed scale) general: thin man in no acute distress but intermittently with spontaneous painful full-body muscle contractions heent: negative chvostek's sign neck: jvp 9 cm, no cervical/supraclavicular lymphadenopathy chest: pes excavatum; clear to auscultation throughout without wheezes, rales, or ronchi cv: tachycardic, regular, iii/vi systolic murmur loudest at rusb; no rubs abdomen: soft, nontender, nondistended, normal bowel sounds, no hsm extremities: left av fistula (+) thrill; 2+ right radial pulse; 1+ pt pulses bilaterally; no edema skin: no rashes or jaundice; thick fibrotic skin diffusely neuro: alert & oriented x3, cn 2-12 intact (except for bilateral hearing difficulty requiring hearing aides), 5/5 strength in bilateral deltoids, biceps, triceps, hip flexors/extensors, ankle flexors/extensors; negative chvostek's sign pertinent results: 08:53am hgb-7.1* calchct-21 02:39pm hct-23.9* . 08:50am wbc-5.6 rbc-2.23*# hgb-6.8*# hct-20.3*# mcv-91 mch-30.5 mchc-33.5 rdw-17.6* 08:50am neuts-62 bands-0 lymphs-30 monos-4 eos-4 basos-0 atyps-0 metas-0 myelos-0 . 08:50am glucose-145* urea n-41* creat-4.2*# sodium-141 potassium-3.7 chloride-98 total co2-34* anion gap-13 08:50am calcium-7.1* phosphate-1.8* magnesium-1.4* 08:53am freeca-0.84* . 08:50am alt(sgpt)-14 ast(sgot)-20 ld(ldh)-188 ck(cpk)-76 alk phos-214* tot bili-0.4 08:50am lipase-108* . 08:50am ctropnt-0.06* . discharge labs: wbc rbc hgb hct mcv mch mchc rdw plt ct 06:45am 4.6 3.22* 9.5* 27.8* 87 29.5 34.1 17.2* 124 glucose urean creat na k cl hco3 angap 06:45am 82 35* 3.5*# 144 3.9 104 32 12 calcium phos mg 06:45am 8.9 2.2* 1.7 . . studies: ecg (): sinus tachycardia at 107 bpm, nl axis, nl intervals, st segment depressions v2-v4. no t wave changes. egd : esophagus: lumen: a small size hiatal hernia was seen. mucosa: a 1.5 cm adherent clot was found at the level of the schatzki's ring in the distal esophagus near the ge junction. epinephrine was injected and the clot fell off on its own into the stomach. underlying the site of prior clot was a tear in the mucosa of the esophagus with no visible vessel identified. epinephrine, total of 15cc, was injected at the site and 3 slips were deployed with good effect and no residual bleeding. brief hospital course: 68yo male with h/o alports syndrome on hd for 40years, and nephrogenic systemic fibrosis treated with imatinib admitted with hematemesis and hypotension and found to have a ge junction visible vessel on egd. he was treated with 3 clips and epi for hemostasis. he received 4u prbc and stabilized. after the procedure pt reported chest discomfort ultimately believed to be due to his egd but concerning for acs-no ekg changes. . plan: upper gi bleed- endoscopy showed a 1.5 cm adherent clot was found at the level of the schatzki's ring in the distal esophagus near the ge junction. epinephrine was injected and the clot fell off on its own into the stomach. underlying the site of prior clot was a tear in the mucosa of the esophagus with no visible vessel identified. epinephrine, total of 15cc, was injected at the site and 3 slips were deployed with good effect and no residual bleeding. pantoprazole 40 mg iv q12h subsequently switched to ppi po. received 4units prbcs and 2l ns with resultant hematocrit 20->23.9.-->29-->27.8 at time of discharge. his imatinib was held since it can cause hemorrhage. post egd tolerated soft mechanical diet well, per gi to have soft mechanical diet, discussed with outpatient gi physician, regular diet at home and continue omeprazole until seen by outpatient gastroenterologist. . hypotension: treated with fluids and transfusion. likely due to volume depletion from brisk upper gi bleed; resolved since coming to micu. fluid resuscitation as above. held lisinopril. restarted prior to discharge as he remained hemodynamically stable. . chest pain: sounds more like post-procedural after clips placed. changed with inspiration not with activity. troponins slightly positive in setting of esrd with dialysis. ekgs with no change from priors. remained chest pain free. . hypocalcemia: on admission symptomatic causing tetanic spasming 4 grams calcium gluconate x2 given. followup ionized calcium later in day was 1.02. held cinacalcet which he was on for his parathyroid disease. . ckd v due to alport syndrome: on dialysis qmwf with l foreare av fistula held phosphate binders since patient was npo and hypophosphatemic. at time of discharge his ca normal and phos slowly increased but still low post hd. plan to have lytes checked at hd prior to resuming phos binders. . nephrogenic systemic fibrosis: longstanding, treated with imatinib per research protocol at . held imatinib as above to resume per pcp. aware not to resume this medication. . fen: npo including meds. advanced to clears as tolerated post-egd. tolerated soft mechanical diet prior to discharge, plan to resume regular diet at home, discussed with gi and outpt gi physician. /mg repletion; held phosphate binders. . code: full, confirmed with patient communication: with patient; wife (home ; cell ) . dispo: home . medications on admission: medications: - imatinib 200 mg daily (just self-reduced from 400 mg 5-6 days ago; began therapy early ) - cinacalcet 60 mg qhs - sevelamer 1600 mg with meals - venlafaxine 300 mg daily - aspirin 81 mg daily - mirtazipine 30 mg qhs - omeprazole 20 mg daily - folic acid 1 mg daily - lisinopril 2.5 mg qhs (only on non-dialysis days) - nephrocaps 1 daily - docusate discharge medications: 1. mirtazapine 15 mg tablet sig: two (2) tablet po hs (at bedtime). 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 4. venlafaxine 75 mg capsule, sust. release 24 hr sig: four (4) capsule, sust. release 24 hr po daily (daily). 5. lisinopril 5 mg tablet sig: 0.5 tablet po non-hd days (). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day: until you see your gi physician. discharge disposition: home discharge diagnosis: primary: -ugib -hypotension -chest pain nos . secondary: -alport's syndrome -esrd on hd -nephrogenic sclerosis -secondary hyperparathyroidism -as discharge condition: stable, tolerating soft mechanical diet well. discharge instructions: you were admitted for an upper gi bleed, you received 4units packed red cell transfusions, you had no further bleeding subsequent to an upper endoscopy. . if you have further emesis of , black stools or noticed from your rectum, feel lightheaded, dizzy, have chest pain or other concerning symptoms, call your physician or go to the emergency department. . please note the following medication changes: -your aspirin was held--discuss this with your primary care physician to resume imitinab was also held-discuss this with your specialist-when safe to resume -your sevelemer was held due to low phosphate--have your labs checked at dialysis to resume -per the gi team you may continue omeprazole twice per day, until you see your gastroenterologist, dr. next week. . you may resume a regular diet at home. followup instructions: follow up with your primary care physician weeks, call his office for an appointment at . . follow up with your gastroenterologist, dr. in 1 week, he is expecting to see you in follow up as discussed with the gi physicians. procedure: venous catheterization, not elsewhere classified endoscopic excision or destruction of lesion or tissue of esophagus diagnoses: chronic kidney disease, stage v hypocalcemia acute posthemorrhagic anemia hematemesis volume depletion, unspecified other specified congenital anomalies 

Answer: The patient is high likely exposed to