Possible recurrence of desquamative interstitial pneumonitis in a single lung transplant recipient

Abstract

Idiopathic pulmonary fibrosis (cryptogenic fibrosing alveolitis) is a disorder with a very poor prognosis for patients who do not respond to therapy with corticosteroids alone or in combination with immunosuppressive drugs, e.g. cyclophosphamide or azathioprine. For patients with end-stage disease, lung transplantation remains the only possibility for long-term survival. We describe a patient who received a left single lung transplant for end-stage desquamative interstitial pneumonitis. One year later, the patient again began complaining of exertional dyspnoea and a gradual decline in the transfer factor of the lung for carbon monoxide (TL,CO) was apparent. A recurrence of the primary disease in the transplanted lung was suspected on transbronchial biopsies. During treatment with high doses of steroids, a Pneumocystis carinii pneumonia developed, which was treated with co-trimoxazole. The patient completely recovered and, after a period of over 2 yrs, remained in an excellent condition, after which time he was lost from follow-up.

Smoking-related interstitial lung diseases: a concise review

“…In the case series reported by Carrington et al [10], 11 (27.5%) of 40 patients died after an average survival of 12 yrs. Late relapse [29] as well as recurrence in transplanted lung has been reported [30,31]. These reports do not specify whether smoking was a factor in the recurrence of DIP.…”

An integrated approach in the diagnosis of smoking-related interstitial lung diseases

“…In ,25% of patients, however, progression of disease may be observed despite steroid therapy [11,59,89] and lung transplantation may be an option. Recurrence has also been reported in patients who have received a lung transplant [90].…”

Re-activation of IPF and Appearance of Cancer on the Native Lung after Single Lung Transplantation

“…The recurrence of IPF in the transplanted lung was excluded. In medical literature there's only one described case of recurrence of IPF (subgroup "desquamative interstitial pneumonia") in a single lung transplant recipient [9].…”