A 42-Year-Old Woman With Anemia, Shock, and Ischemic Stroke After Lung Transplantation

Chest. 2017 Mar;151(3):e63-e68. doi: 10.1016/j.chest.2016.09.006.

Abstract

A 42-year-old woman with mixed connective tissue disease-associated interstitial lung disease underwent bilateral lung transplantation. She had an uneventful surgery and was extubated 3 h later. Induction immunosuppression therapy included methylprednisolone 500 mg intraoperatively, basiliximab (anti-IL-2 monoclonal antibody) on days 0 and 4 after transplantation, and methylprednisolone 125 mg intravenously bid for 2 days following surgery. Maintenance immunosuppression therapy consisted of prednisone 20 mg daily, mycophenolate mofetil 750 mg bid, and enteral tacrolimus 0.5 mg bid. Both the donor and the recipient were seropositive for cytomegalovirus. Infectious disease prophylaxis consisted of valganciclovir, trimethoprim-sulfamethoxazole, and voriconazole.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology
  • Adult
  • Anemia / diagnosis*
  • Anemia / etiology
  • Anemia / therapy
  • Atypical Hemolytic Uremic Syndrome / complications
  • Atypical Hemolytic Uremic Syndrome / diagnosis*
  • Blood Transfusion
  • Echocardiography
  • Female
  • Graft Rejection / prevention & control
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infarction, Middle Cerebral Artery / diagnostic imaging*
  • Lung Diseases, Interstitial / etiology
  • Lung Diseases, Interstitial / surgery*
  • Lung Transplantation*
  • Magnetic Resonance Imaging
  • Mixed Connective Tissue Disease / complications
  • Postoperative Complications / diagnosis*
  • Shock / diagnosis*
  • Shock / etiology
  • Stroke / diagnostic imaging*
  • Stroke / etiology
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / etiology
  • Thrombocytopenia / therapy

Substances

  • Immunosuppressive Agents