Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient

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 impro...

Full description

Saved in:
Bibliographic Details
Main Authors: Kamyar Afshar, A. Purush Rao, Vipul Patel, Kevin Forrester, Sivagini Ganesh
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Journal of Transplantation
Online Access:http://dx.doi.org/10.1155/2011/919651
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849309150386847744
author Kamyar Afshar
A. Purush Rao
Vipul Patel
Kevin Forrester
Sivagini Ganesh
author_facet Kamyar Afshar
A. Purush Rao
Vipul Patel
Kevin Forrester
Sivagini Ganesh
author_sort Kamyar Afshar
collection DOAJ
description 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.
format Article
id doaj-art-0d4942b1a38444fb91c69b9b63e9554c
institution Kabale University
issn 2090-0007
2090-0015
language English
publishDate 2011-01-01
publisher Wiley
record_format Article
series Journal of Transplantation
spelling doaj-art-0d4942b1a38444fb91c69b9b63e9554c2025-08-20T03:54:15ZengWileyJournal of Transplantation2090-00072090-00152011-01-01201110.1155/2011/919651919651Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant RecipientKamyar Afshar0A. Purush Rao1Vipul Patel2Kevin Forrester3Sivagini Ganesh4Division of Pulmonary and Critical Care, University of Southern California, Keck School of Medicine, 2020 Zonal Avenue, IRD 723, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care, University of Southern California, Keck School of Medicine, 2020 Zonal Avenue, IRD 723, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care, University of Southern California, Keck School of Medicine, 2020 Zonal Avenue, IRD 723, Los Angeles, CA 90033, USADepartment of Clinical Pharmacy and Pharmaceutical Economics and Policy, University of Southern California, 1985 Zonal Avenue, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care, University of Southern California, Keck School of Medicine, 2020 Zonal Avenue, IRD 723, Los Angeles, CA 90033, USAPosttransplant 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.http://dx.doi.org/10.1155/2011/919651
spellingShingle Kamyar Afshar
A. Purush Rao
Vipul Patel
Kevin Forrester
Sivagini Ganesh
Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient
Journal of Transplantation
title Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient
title_full Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient
title_fullStr Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient
title_full_unstemmed Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient
title_short Use of Foscarnet Therapy for EBV Infection following Control of PTLD with Enhancement of Cellular Immunity in a Lung-Transplant Recipient
title_sort use of foscarnet therapy for ebv infection following control of ptld with enhancement of cellular immunity in a lung transplant recipient
url http://dx.doi.org/10.1155/2011/919651
work_keys_str_mv AT kamyarafshar useoffoscarnettherapyforebvinfectionfollowingcontrolofptldwithenhancementofcellularimmunityinalungtransplantrecipient
AT apurushrao useoffoscarnettherapyforebvinfectionfollowingcontrolofptldwithenhancementofcellularimmunityinalungtransplantrecipient
AT vipulpatel useoffoscarnettherapyforebvinfectionfollowingcontrolofptldwithenhancementofcellularimmunityinalungtransplantrecipient
AT kevinforrester useoffoscarnettherapyforebvinfectionfollowingcontrolofptldwithenhancementofcellularimmunityinalungtransplantrecipient
AT sivaginiganesh useoffoscarnettherapyforebvinfectionfollowingcontrolofptldwithenhancementofcellularimmunityinalungtransplantrecipient