POSSIBLE RECURRENCE OF DESQUAMATIVE INTERSTITIAL PNEUMONITIS IN A SINGLE-LUNG TRANSPLANT RECIPIENT

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 immunosuppr essive 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 sing le lung transplant for end-stage desquamative interstitial pneumonitis . One year later, the patient again began complaining of exertional dy spnoea and a gradual decline in the transfer factor of the lung for ca rbon monoxide (TL,CO) was apparent, A recurrence of the primary diseas e in the transplanted lung was suspected on transbronchial biopsies. D uring treatment with high doses of steroids, a Pneumocystis carinii pn eumonia 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.