title: Posttransplant lymphoproliferative disorder in an 11-year-old immunosuppressed boy.
abstract: We present an 11-year-old boy who presented with symptoms of subacute facial nerve palsy after cardiac transplant. Neuroimaging revealed multiple ring-enhancing lesions that were most concerning for opportunistic organism abscesses and he was treated with broad-spectrum antifungal and antibacterial therapy. After noninvasive testing failed to identify a causative organism, he underwent brain biopsy. Pathology revealed posttransplant lymphoproliferative disease that was later determined to be isolated to the central nervous system. The patient was treated with reduction in his immunotherapy and chemotherapy including rituximab and methotrexate. This case exemplifies the importance of having a low threshold to consider posttransplant lymphoproliferative disease in posttransplant patients.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Nelson
authors.forename: Radhika
authors.initials: R
authors.lastname: Dhamija
authors.forename: Katherine
authors.initials: K
authors.lastname: Nickels
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D002648:Child; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D018908:Muscle Weakness / Q000209:etiology; D000069283:Rituximab; D000077204:Temozolomide
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000069283:Rituximab; D003606:Dacarbazine; D000077204:Temozolomide; D008727:Methotrexate