title: Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient.
abstract: Posttransplant lymphoproliferative disorder (PTLD) is a serious complication following solid organ transplantation with an annual incidence rate of 3-5% in lung-transplant recipients. Pathogenesis indicates a strong association with functional over-immunosuppression and EBV infection. Clinical improvement is generally observed with reduction in immunosuppression intensity alone. We present a case of a 24-year-old woman with EBV-associated PTLD following lung transplant where decreasing the immunosuppression improved PTLD but was ineffective against controlling the EBV infection. Foscarnet in combination with immunoglobulins was successfully administered to cause a remission of the EBV infection. This is the second case reported of a persistent EBV infection after reducing immunosuppression levels and evidence of PTLD remission that required foscarnet for EBV infection control.
authors.affiliation: Division of Pulmonary and Critical Care, University of Southern California, Keck School of Medicine, 2020 Zonal Avenue, IRD 723, Los Angeles, CA 90033, USA.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Afshar
authors.forename: A Purush
authors.initials: AP
authors.lastname: Rao
authors.forename: Vipul
authors.initials: V
authors.lastname: Patel
authors.forename: Kevin
authors.initials: K
authors.lastname: Forrester
authors.forename: Sivagini
authors.initials: S
authors.lastname: Ganesh