title: A 48-Year-Old Man With Leukopenia, Jaundice, and Skin Rash After Lung Transplantation.
abstract: A 48-year-old African-American male subject presented with progressive fatigue, jaundice, and new-onset leukopenia 12 weeks after undergoing bilateral lung transplantation for advanced pulmonary sarcoidosis. His transplant surgery and immediate posttransplantation course were uneventful. Induction immunosuppression included methylprednisolone 500 mg intraoperatively and basiliximab (anti-IL-2 monoclonal antibody) on days 0 and 4 after transplantation. His maintenance immunosuppression posttransplantation was prednisone 20 mg daily, tacrolimus with target tacrolimus levels 10 to 15 ng/mL, and mycophenolate mofetil 750 mg twice daily. Both the donor and recipient were seropositive for cytomegalovirus and Epstein-Barr virus. Infectious disease prophylaxis consisted of valganciclovir, trimethoprim/sulfamethoxazole, and voriconazole. Results of the surveillance bronchoscopy conducted after the lung transplant were negative for acute cellular rejection or infection at 4 and 12 weeks' posttransplantation. Findings on spirometry had continuously improved since transplantation.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL.
authors.forename: Ali
authors.initials: A
authors.lastname: Ataya
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Biswas
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL.
authors.forename: Satish
authors.initials: S
authors.lastname: Chandrashekaran
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Salgado
authors.affiliation: Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Goldstein
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL. Electronic address: amir.emtiazjoo@medicine.ufl.edu.
authors.forename: Amir M
authors.initials: AM
authors.lastname: Emtiazjoo
mesh_terms: D003937:Diagnosis, Differential; D004890:Erythema; D017809:Fatal Outcome; D006086:Graft vs Host Disease / Q000175:diagnosis*; D006801:Humans; D007565:Jaundice; D007970:Leukopenia; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged