Influenza A Pneumonitis Following Treatment of Acute Cardiac Allograft Rejection with Murine Monoclonal Anti-CD3 Antibody (OKT3)
| Autor: | Richard P. Embrey, Lois J. Geist |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Graft Rejection
Male Pulmonary and Respiratory Medicine medicine.medical_treatment Pneumonia Viral Orthomyxoviridae Amantadine Hydrochloride Critical Care and Intensive Care Medicine medicine.disease_cause Antiviral Agents Muromonab-CD3 Immunocompromised Host chemistry.chemical_compound Postoperative Complications Ribavirin Amantadine Influenza A virus medicine Humans Pneumonitis Virulence biology business.industry Immunosuppression Middle Aged biology.organism_classification medicine.disease chemistry Immunology Heart Transplantation Cardiology and Cardiovascular Medicine business Immunosuppressive Agents medicine.drug |
| Zdroj: | Chest. 108:1456-1459 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.108.5.1456 |
| Popis: | A 51-year-old man developed fever, cough, and dyspnea 5 days after completing murine monoclonal anti-CD3 antibody (OKT3) treatment for acute cardiac allograft rejection. Samples of BAL fluid grew influenza A virus. Progressive pulmonary infiltrates, respiratory compromise, and hypoxia developed, and the patient ultimately required 5 days of mechanical ventilation. Treatment with amantadine hydrochloride and ribavirin was prescribed, and the patient was discharged after 19 days. Influenza A virus has not been an important pathogen in cardiac transplant recipients. However, this is the first reported case of influenza A pneumonitis complicating anti-T lymphocyte therapy for cardiac allograft rejection. In comparison with our patient, two previously reported cases of influenza A infection in cardiac transplant patients have been less severe. The virulence of our patient's, life-threatening infection appears to be secondary to impairment of T lymphocyte-mediated immunity by OKT3. The role of therapeutic and even prophylactic amantadine therapy in this clinical setting has yet to be determined. |
| Databáze: | OpenAIRE |
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