Acute measles infection triggering an episode of liver transplant rejection.
We report the case of a 31-year-old immunosuppressed, liver transplanted man, with acute measles infection. The vaccinated patient had been exposed to measles during a known measles epidemic in public schools in Austria between January and April 2008. Measles infection triggered an episode of acute liver transplant rejection. The diagnosis of measles infection was made clinically and by serologic tests. Transplant rejection was diagnosed by liver biopsy. The transplant rejection was treated successfully. Liver transplant patients are at an increased risk for infection during epidemic outbreaks, even after pre-transplant vaccination, as immunity may wane over time.
Sternfeld
T
T
II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 Munich, Germany. thomas.sternfeld@lrz.tum.de
Spöri-Byrtus
V
V
Riediger
C
C
Langer
R
R
Friess
H
H
Schmid
R M
RM
Schulte-Frohlinde
E
E
D000208:Acute Disease; D000328:Adult; D001317:Austria / Q000453:epidemiology; D004196:Disease Outbreaks; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006084:Graft Rejection / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008457:Measles / Q000150:complications* / Q000453:epidemiology; D008775:Methylprednisolone / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000627:therapeutic use; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use
D004791:Enzyme Inhibitors; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus; D008775:Methylprednisolone