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Lymphocytic myocarditis after lung transplantation.
Justin Weinkauf1, Rajat Walia, Gerald J Berry
1Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, California, USA.
Summary
A lung transplant recipient developed lymphocytic myocarditis due to Epstein-Barr virus (EBV) reactivation. Prompt treatment with valacyclovir led to a full recovery, highlighting the importance of monitoring EBV in transplant patients.
Area of Science:
- Cardiology
- Transplantation Immunology
- Infectious Diseases
Background:
- Cystic fibrosis patients undergoing lung transplantation are at risk for post-transplant complications.
- Epstein-Barr virus (EBV) reactivation can occur in immunosuppressed individuals, including organ transplant recipients.
Observation:
- A 23-year-old bilateral lung allograft recipient presented with congestive heart failure and severe left ventricular dysfunction 32 months post-transplant.
- The patient had a history of infectious mononucleosis and was on oral acyclovir.
- Elevated Epstein-Barr virus (EBV) viral load was detected.
Findings:
- Echocardiogram showed a left ventricular ejection fraction of 25%.
- Endomyocardial biopsy confirmed lymphocytic myocarditis.
- Treatment with valacyclovir resulted in complete recovery within 6 months.
Implications:
- This case highlights a rare complication of lymphocytic myocarditis following lung transplantation.
- Monitoring EBV viral load is crucial in lung allograft recipients to prevent or manage complications.
- Early diagnosis and antiviral treatment can lead to favorable outcomes in EBV-related myocarditis.