Pulmonary re-occurrence of post-transplant lymphoproliferative disease with hypogammaglobulinaemia.
We report the case of a 12-year-old boy, who developed Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disease (PTLD) 7 years after renal transplantation. He responded well to the reduced immunosuppressive therapy and treatment with ganciclovir. Two years later he developed severe pneumonia and hypogammaglobulinaemia related to EBV infection exacerbation. An X-ray film revealed persistent pneumonia in the right lung. Lung biopsy showed a large, diffuse EBV-associated B-cell lymphoma. This constellation suggested re-occurrence of the primary PTLD.


CONCLUSIONS
We present a case of recurring Epstein-Barr virus-associated post-transplant lymphoproliferative disease with a remarkably late onset in addition to hypogammaglobulinaemia.
Wolf
Matthias T F
MTF
Department of Paediatrics, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, 12200 , Berlin, Germany.
Mildenberger
Eva
E
Department of Paediatrics, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, 12200 , Berlin, Germany. eva.mildenberger@ukbf.fu-berlin.de.
Lennert
Thomas
T
Department of Paediatrics, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, 12200 , Berlin, Germany.
Anagnostopoulos
Ioannis
I
Department of Pathology, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Berlin, Germany.
Zinn
Christina
C
Department of Paediatrics, Otto-Heubner-Centrum für Kinder- und Jugendmedizin der Charité, Berlin, Germany.
Paul
Karl
K
Department of Paediatrics, Otto-Heubner-Centrum für Kinder- und Jugendmedizin der Charité, Berlin, Germany.
Keitzer
Rolf
R
Department of Paediatrics, Otto-Heubner-Centrum für Kinder- und Jugendmedizin der Charité, Berlin, Germany.
Versmold
Hans
H
Department of Paediatrics, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, 12200 , Berlin, Germany.
D000361:Agammaglobulinemia / Q000209:etiology* / Q000821:virology; D002471:Cell Transformation, Neoplastic; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000209:etiology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D016393:Lymphoma, B-Cell / Q000209:etiology* / Q000821:virology; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000821:virology; D008297:Male; D011014:Pneumonia / Q000209:etiology; D012008:Recurrence