TY - JOUR
T1 - An unusual cause of respiratory failure in a 25-year-old heart and lung transplant recipient
AU - Narotzky, Sarah
AU - Kennedy, Cassie Colleen
AU - Maldonado, Fabien
N1 - Publisher Copyright:
© 2015 American College Of Chest Physicians.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - A 25-year-old woman, a never smoker with a history of heart-lung transplantation for World Health Organization group 1 pulmonary arterial hypertension performed 20 months prior to presentation, was evaluated for shortness of breath. Following transplantation, she was initiated on standard therapy of prednisone, tacrolimus, and azathioprine, along with routine antimicrobial prophylaxis. Her posttransplant course was complicated by persistent acute cellular rejection, as determined from a transbronchial biopsy specimen, without evidence of rejection in an endomyocardial biopsy specimen. The immunosuppressive medications were supplemented with pulse-dosed steroids, and the patient was transitioned from azathioprine to mycophenolate mofetil. Sirolimus was added 9 months prior to presentation. Three months prior to presentation, she was admitted for increasing oxygen requirements, shortness of breath, and bilateral infi ltrates on the CT scans of the chest.
AB - A 25-year-old woman, a never smoker with a history of heart-lung transplantation for World Health Organization group 1 pulmonary arterial hypertension performed 20 months prior to presentation, was evaluated for shortness of breath. Following transplantation, she was initiated on standard therapy of prednisone, tacrolimus, and azathioprine, along with routine antimicrobial prophylaxis. Her posttransplant course was complicated by persistent acute cellular rejection, as determined from a transbronchial biopsy specimen, without evidence of rejection in an endomyocardial biopsy specimen. The immunosuppressive medications were supplemented with pulse-dosed steroids, and the patient was transitioned from azathioprine to mycophenolate mofetil. Sirolimus was added 9 months prior to presentation. Three months prior to presentation, she was admitted for increasing oxygen requirements, shortness of breath, and bilateral infi ltrates on the CT scans of the chest.
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U2 - 10.1378/chest.14-1443
DO - 10.1378/chest.14-1443
M3 - Article
C2 - 25940262
AN - SCOPUS:84929471793
SN - 0012-3692
VL - 147
SP - e185-e188
JO - Chest
JF - Chest
IS - 5
ER -