title: Invasive Tracheobronchial Aspergillosis in a Lung Transplant Recipient Receiving Belatacept as Salvage Maintenance Immunosuppression: A Case Report.
abstract: BACKGROUND
  The association between belatacept, a CD28 costimulation blocker, and invasive mycoses is unclear.
  
  
  METHODS
  We describe a patient who initiated belatacept 3 years after lung transplantation and developed invasive tracheobronchial aspergillosis, a disease encountered almost exclusively within the first 6 months after transplantation.
  
  
  CONCLUSIONS
  Belatacept may have played a causative role. Until more data are available, belatacept should be used cautiously after lung transplantation.
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address: haidarg@upmc.edu.
authors.forename: G
authors.initials: G
authors.lastname: Haidar
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: M
authors.initials: M
authors.lastname: Crespo
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: S
authors.initials: S
authors.lastname: Maximous
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: E
authors.initials: E
authors.lastname: Lendermon
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Clancy
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Nguyen
mesh_terms: D000069594:Abatacept / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D055744:Invasive Pulmonary Aspergillosis / Q000139:chemically induced* / Q000473:pathology; D016040:Lung Transplantation; D008875:Middle Aged; D016879:Salvage Therapy / Q000009:adverse effects* / Q000379:methods; D014132:Trachea / Q000382:microbiology
chemical_list: D007166:Immunosuppressive Agents; D000069594:Abatacept