Influenza A Pneumonitis Following Treatment of Acute Cardiac Allograft Rejection with Murine Monoclonal Anti-CD3 Antibody (OKT3)

Richard P Embrey; Lois J Geist

doi:10.1378/chest.108.5.1456

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Influenza A Pneumonitis Following Treatment of Acute Cardiac Allograft Rejection with Murine Monoclonal Anti-CD3 Antibody (OKT3)

Journal article

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Influenza A Pneumonitis Following Treatment of Acute Cardiac Allograft Rejection with Murine Monoclonal Anti-CD3 Antibody (OKT3)

Richard P Embrey and Lois J Geist

Chest, Vol.108(5), pp.1456-1459

11/1995

DOI: 10.1378/chest.108.5.1456

PMID: 7587460

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Abstract

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.

cardiac transplantation

immunosuppression

influenza A

OKT3

Details

Title: Subtitle: Influenza A Pneumonitis Following Treatment of Acute Cardiac Allograft Rejection with Murine Monoclonal Anti-CD3 Antibody (OKT3)
Creators: Richard P Embrey - Division of Cardiothoracic Surgery, University of Iowa College of Medicine, Iowa City
Lois J Geist - Division of Pulmonary Medicine, University of Iowa College of Medicine, Iowa City
Resource Type: Journal article
Publication Details: Chest, Vol.108(5), pp.1456-1459
DOI: 10.1378/chest.108.5.1456
PMID: 7587460
NLM abbreviation: Chest
ISSN: 0012-3692
eISSN: 1931-3543
Publisher: Elsevier Inc
Language: English
Date published: 11/1995
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Provost Office Administration; Internal Medicine
Record Identifier: 9984213293602771

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