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Late onset Pneumocystis pneumonia in renal transplantation after long‐term immunosuppression with belatacept
Author(s) -
Haidinger M.,
Hecking M.,
Memarsadeghi M.,
Weichhart T.,
Werzowa J.,
Hörl W.H.,
Säemann M.D.
Publication year - 2009
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2009.00366.x
Subject(s) - belatacept , medicine , immunosuppression , pneumocystis jirovecii , pneumocystis pneumonia , pneumonia , regimen , cytomegalovirus , immunology , transplantation , kidney transplantation , kidney transplant , herpesviridae , human immunodeficiency virus (hiv) , viral disease
Interference with T‐cell function increases the risk of infections, especially during the early post‐transplant period. Belatacept, a costimulation blocker, is currently being tested in phase III clinical trials. Here we report a renal transplant recipient who received belatacept and developed severe Pneumocystis jirovecii pneumonia (PCP) with fatal superinfections 4 years post transplant. Cytomegalovirus infection preceded PCP, which typically occurs in overimmunosuppressed patients, but has not yet been reported under T‐cell costimulation blockade in transplant patients. This case illustrates the possibility of excessive immunosuppression even with a lymphocyte‐specific regimen.