Post-Transplant Lymphoproliferative Disease Case Study

Clinical Manifestations: (What are the textbook signs & symptoms of the disease? *Highlight the s/s your patient has.)

Patients who underwent this procedure had to remain on immunosuppressive drugs for about 6 months to prevent the recipient’s immune system from destroying the donor cell. One out of seven patients that had this procedure done had a relapse because they stopped taking their immunosuppressant drug during the critical stage of treatment. This treatment has proven successful, but there still remains the concern of tissue rejection and other complication. Nevertheless, this approach still provides encouragement for people suffering with the disease.

Lupus can be managed with Acetaminophen or NSAIDS. (S) Additionally, the Food and Drug Administration approves the uses of corticosteroids, including prednisone, a medication also given to those right after transplant that acts as an immunosuppressant drug. (S) Immunosuppressant drugs are vital to the success of transplanted organ because they prevent the immune system from attacking the transplanted organ if it is not closely matched. As mentioned before, without these drugs, the body will begin to recognize the tissue as a foreign body. In organ transplant cases, patients may be on the medication for the rest of their life, whereas the treatment for Lupus can be short term (flare-ups) or long

This chronic and often unpredictable disease can cause a wide range of symptoms, including, but not in any way limited to:

HPI: Pt presents with c/o increased SOB that has worsen over the last few months. Chronic cough that is occasionally productive with whitish sputum. Hinders his ADLs.

Signs and symptoms are the first steps into identifying if one has this autoimmune disease. Symptoms include the following; extreme fatigue, weight loss, decreased appetite, hyperpigmentation, hypotension, fainting, hypoglycemia, nausea, diarrhea, vomiting, pain in the abdominal region, muscle/joint pains, body hair loss, and sexual dysfunction.

difficult to work with because each case is different, and the course of this disease is

This is an up dated review of the disease, manifestations, and potential treatment options available.

When evaluating the recent onset of regional lymphadenopathy in a teenager, there are various etiologies that should be explored. Lymphadenopathy is often a benign entity that is self-limiting but can also be the presenting sign of a more serious illness. Our patient had several signs and symptoms that were concerning for both a malignant etiology as well as an infectious cause for his acute, painful lymphadenopathy. Due to the commonality and potentially serious causes of lymphadenopathy, it is important for physicians to be able properly differentiate the more commonly benign causes from the potentially serious illnesses.

There are at least 30 different entities referred to as non-Hodgkin's lymphomas, and they range from the indolent to the very aggressive. Taken together, the non-Hodgkin's lymphomas are the fifth most common cancers in the United States and the fifth leading cause of death due to cancer 1. More than 356,000 cases are diagnosed annually with Non-Hodgkin lymphoma (NHL), however, mortality cases are high as well, evaluated as 192,000 2. NHL is defined as a combination of malignancies originating from T- and B-lymphocytes in the lymph nodes 3, 4. The invasion is not only restricted to the lymphatic system but the central nervous system, the skin, the bone marrow and adrenal glands are commonly affected as well 5, 6. Numerous factors are associated with the progression of NHL as organs

What causes this disease is, after the transplant is complete the cells, of the transplanted bone marrow or stem cell, start attacking the recipient’s body. GVHD has a wide range of how dangerous it can be to the patient’s life, it can range from mild, where it is easily treatable, to life threatening, where there is no stopping the donor cells from attacking the recipient’s body. A biopsy on an affected organ can determine diagnoses of GVHD grade from I (mildest) to IV (most severe). To prevent GVHD, a couple of days before the transplant multiple drugs are prescribed to the patient: cyclosporine and methotrexate, tacrolimus and methotrexate, tacrolimus and mycophenolate mofetil, or prograf and sirolimus. These drugs are to lower the immune system from attacking the donor’s cells. The outlooks of a patient after the transplant is determined on how severe GVHD is and how closely match the bone marrow tissue or cell was. There have been some cases where GVHD caused damage to the liver, lungs, digestive tract and other organs. However, if this does happen or the patient start developing symptoms of GVHD, there are treatments. But the treatments does not always guarantee that the transplant will treat the original disease that was meant for the bone marrow tissue or cell transplant.

Many pathological conditions can be treated through the use of allogeneic transplants. An allogeneic transplant is when cells, tissues, or organs from a donor are placed into a recipient that is genetically different. Because the donor and recipient are not identical, it is possible for the graft to reject, which when there is an immune response against the graft. It is also possible for a more serious complication to occur, known as Graft-versus-host disease. Graft-versus-host disease typically occurs in cases of bone marrow or stem cell transplants, but it can also occur in other cases as well. In this condition, immune cells in the grafted tissue recognize the host body cells as foreign, and attack them. Normally, immune cells do not attack their own body cells due to cell proteins called human leukocyte antigens (HLA). Every person has a different HLA pattern, which makes allogeneic transplants more difficult. For a transplant to be successful,

Colvin, R. B., & R N., Smith. (2015, October). Antibody-mediated organ-allograft rejection : Article ... Retrieved October 19, 2016, from http://www.nature.com/nri/journal/v5/n10/full/nri1702.html

I am very grateful to have my clinical rotation at Bone Marrow Transplant Unit (BMT). Many of my burning questions related to transplantation got answered. Attending BMT physicians mentioned about ?TMA? as a possible diagnosis on different patients during interdisciplinary rounding and conference. One day, I finally had the courage to ask Rosalyn, my preceptor, what is ?TMA?. She was very happy and explained it to me in detail. She also encouraged me to

symptoms that are associated with this disease involve night sweats, itchy skin, fever, fatigue, unintended weight loss, persistent cough, pain in the lymph nodes after having alcohol, and an enlarged spleen. The most known sign of this condition of the swelling in the lymph nodes. This disease is commonly diagnosed by x-rays, CT scans, blood tests, an echocardiogram, or a bone marrow biopsy.