Post-transplant lymphoproliferative disorder presenting as supraglottitis following pediatric heart transplantation treated with EBV-specific cytotoxic T-lymphocytes

Sophie Duignan, Aengus O'Marcaigh, John Russell, Rania Mehanna, Michael McDermott, Matthew Fenton, Colin J McMahon*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

We present the case of a 4 year-old boy post heart transplantation who presented with signs and symptoms of critical airway obstruction and was initially diagnosed with infective supraglottitis. Following re-presentation and biopsy, this was confirmed as post-transplant lymphoproliferative disorder (PTLD) in an unusual site; laryngeal PTLD is rare. The patient failed standard therapy and ultimately was successfully treated with EBV-specific cytotoxic T lymphocytes (CTL). This case describes a rare presentation of PTLD which required a novel treatment approach including elective tracheostomy prior to CTL therapy. The treatment was successful and the patient was decannulated prior to discharge following 4 negative biopsies, the most recent 6 months following treatment completion. The case also highlights the importance of extra-vigilance in the post-transplant population and of a collaborative approach between multiple specialties across two separate countries including the transplant center and the referral center.

Original languageEnglish
Pages (from-to)708-711
Number of pages4
JournalJournal of Heart and Lung Transplantation
Volume41
Issue number6
Early online date6 Mar 2022
DOIs
Publication statusPublished - Jun 2022

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