Possible recurrence of desquamative interstitial pneumonitis in a single lung transplant recipient.
Idiopathic pulmonary fibrosis (cryptogenic fibrosing alveolitis) is a disorder with a very poor prognosis for patients who do not respond to therapy with corticosteroids alone or in combination with immunosuppressive drugs, e.g. cyclophosphamide or azathioprine. For patients with end-stage disease, lung transplantation remains the only possibility for long-term survival. We describe a patient who received a left single lung transplant for end-stage desquamative interstitial pneumonitis. One year later, the patient again began complaining of exertional dyspnoea and a gradual decline in the transfer factor of the lung for carbon monoxide (TL,CO) was apparent. A recurrence of the primary disease in the transplanted lung was suspected on transbronchial biopsies. During treatment with high doses of steroids, a Pneumocystis carinii pneumonia developed, which was treated with co-trimoxazole. The patient completely recovered and, after a period of over 2 yrs, remained in an excellent condition, after which time he was lost from follow-up.
Verleden
G M
GM
Dept of Pulmonary Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
Sels
F
F
Van Raemdonck
D
D
Verbeken
E K
EK
Lerut
T
T
Demedts
M
M
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000209:etiology; D011183:Postoperative Complications; D011658:Pulmonary Fibrosis / Q000188:drug therapy / Q000601:surgery*; D012008:Recurrence; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000890:Anti-Infective Agents; D005938:Glucocorticoids; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D008775:Methylprednisolone